High Risk Home Health

Jovita Ramirez

**** ****** ** • Riverside, CA ***03

Cell: 951-***-****

Email: **************@*****.***

Summary:

Seeking a position within a reputable company with growth opportunities, where I can further utilize my advanced experience for the benefit and success of my team.

Programs: Microsoft: Excel, OneNote, Outlook, Quicken, Quickbooks, PowerPoint, Skype, Sway, Access, Adobe Photoshop and Illustrator, Project, NextGen, Epic, eClinicalWorks, MediTech, nextgen, Allscripts, Praxis, Canva, POS: Shopify, Square, Quickbooks, Verifone, Etsy

Education:

Norte Vista High School - Diploma

Coursera – Canva Certificate, Bookkeeping Basics Certificate, Excel Certificate

Regal Medical Group June 2022 - Present

Prior Authorization Coordinator

Assists Vital Care Case Managers with arranging services for members, such has home health, DME, physician appointments, specialist appointments, and transportation

Follows up with patients to ensure arranged services are received

Processes referral authorization requests for High Risk program patients

Maintains turnaround time compliance in all aspects of the referral authorization process

Assists the High Risk team in developing and implementing chronic disease care programs to improve quality of care for high risk members

Keeps patient and/or family members or other customers informed of care plan and any changes

Assists other staff and supports the team approach

Demonstrates the ability to follow through with requests, sharing of critical information, and getting back to individuals in a timely manner

Demonstrates honesty and integrity in everyday activities

Protects privacy for both patients and employees; ensuring all personal health information is kept confidential i.e., (sensitive papers, charts, and reports are not in view of the public)

Recognizes when an error has been made and immediately reports to appropriate manager

Participates in “service recovery” through follow-up with an upset customer, gathering information, and demonstrating empathy

Treats patients and their families with respect and dignity

Identifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their families

Functions as liaison between administration, patients, physicians, and other healthcare providers

Interacts professionally with other healthcare service providers

Communicates appropriately and clearly to management, co-workers, and physicians

Consults other departments as appropriate to provide for an interdisciplinary approach to the patient's needs

Performs other duties as assigned

Participates in the efficient, effective, and responsible use of resources such as supplies and equipment

Maintains all reference material that is provided by the supervisor, manager or director

Distribution of work: Daily production will vary from day to day

All assigned work must be completed by the end of business day in order to maintain customer service to High Risk patients and referral turnaround time compliance

Ivy Surrogacy – Diamond Bar, CA January 2022 – June 2022

Surrogate Case Coordinator/Manager

Communicate with and support surrogate mom and coordinate the surrogacy arrangement throughout her surrogacy journey.

Oversee all logistics, administrative duties, and relationship management throughout the client engagement and complete surrogacy journey.

Travel to fertility centers, hospitals, and other locations as necessary to provide support during appointments. Travel varies based on the engagement and may be local, regional, or national.

Work closely with internal team internally (Intake Manager, Client Manager, etc.) and externally (IVF clinics, Attorney, insurance companies, travel agencies, etc.) to provide best experience to surrogates and intended parents.

Organize social media and meet-up events and other innovative ways to grow surrogate & egg donor database

Act as the first point of contact with inquiring surrogates to help candidate understand the requirement, process and benefits

Proactively follow-up and make appropriate phone calls and send emails to the potential surrogate candidates to gather information, prescreen and instruct candidate to fill full application

Request and maintain medical records

Work closely with intended parent coordinator on matching and case management

Original Craft Handyman Services Inc.- Remote On call September 2011 - Present

Administrative Assistant

●QuickBooks

●Match Invoices

●Invoice customers. Upon approval, distribute invoices to customers via email or mail.

●Make bank de posits, order checks, verify bank drafts and charges, and resolve bank errors

●Answer questions from vendors, employees, and customers about their bills, paychecks, and invoices.

●Ability to communicate effectively, both orally and in writing.

●Knowledge of general office procedures, such as copying, faxing, filing, and shredding.

●Attention to detail. Accurate.

●Manage bills received from vendors

●Record bank transactions as needed.

●Make journal entries as directed.

●Ability to work independently and as a member of a team / Capable of multi-tasking

Sense of urgency / Positive attitude and energetic / Follow-up skills are imperative

●Track the cash balance and alert owner or manager with regular cash flow reports.

● Reconcile bank, customer, and vendor accounts

JLife Creations – Remote March 2020 – Present

Online Retail Shop Owner

List Items on online store front

Develop and maintain online retail venue.

Create store front, develop and create products, maintain inventory, manage marketing and advertising of shop.

Design, product development

Create Custom orders

Set up as a vendor at craft shows to sell my products and take new orders

Responsible for Bookkeeping and ordering inventory

Bristol Hospice - Orange, CA September 2021 – December 2021

Intake Coordinator

Evaluates hospitalized patients referred for hospice.

Identifies and verifies insurance coverage of hospice services.

Obtains and documents prior authorization for hospice services from insurance providers.

Collaborates with the hospital's discharge planning personnel, utilization review department and insurance Case Managers to facilitate safe, early discharge.

Consults with physicians, nurses, social workers, discharge planners and other disciplines to establish a coordinated home plan of care.

Interviews the patient, family, and caregiver and discusses the home situation, current needs, and any psychosocial factors that are relevant to the plan of care.

Completes referral information that includes intake data, essential background information, hospital course, and the plan of care.

Maintains liaison relationship with hospital and insurance personnel, providing information and education on Organization services, coverage issues and related areas.

Participates in patient care conferences and in-services.

Collects and maintains statistical data on all referrals and submits them regularly as required.

Attends meetings and participates on committees as required.

Participation in Quality Assurance/Performance Improvement Program and Hospice Agency sponsored training.

Performs other duties as assigned.

New American Funding Inc – Remote, CA August 2020 – August 2021

Verification of Employment Specialist Took this position to get through Covid Quarantine

Responsible for contacting current and previous employers of borrowers to verify employment prior to pre-approving a borrower for a home purchase.

Responsible for calling the HR departments of borrowers in order to verify employment

Responsible for doing both written and verbal VOEs

Conduct VOEs from coast to coast, different time zones

Conduct about 50 VOEs daily

Perform other duties as assigned

Familiarity with completing written verifications of employment

Customer Service

Pacific Reproductive Center- Corona, CA December 2014 – August 2020

Marketing Coordinator/ Front Office Coordinator/ New Patient Liaison

● Support the marketing department's initiatives with the planning, executing, and tracking of marketing programs such as email, event, social media, or content marketing

●Completed google ads certification

●Independently coordinate marketing and community events, including overseeing logistics, managing registrations, coordinating with vendors, creating itineraries, and ordering marketing collateral

●Coordinate product, event, or content email marketing campaigns, including copy, scheduling, testing, and database management

●Create, proofread, and edit copy for various marketing channels, ensuring consistent voice

●Assist with developing and managing content and social media marketing programs, including blogs and public relations efforts

●Evaluate and monitor campaign performance on an ongoing basis by analyzing key metrics and creating comprehensive reports

●Manage relationships with external vendors to ensure high-quality and timely execution of marketing programs, and to ensure competitiveness

●Conduct market research and identify trends

●Respond to Online and telephone Inquiries Meet with patients to coordinate upcoming procedures, review requirements, calendars, and medications.

●Care Coordinating worked closely with the providers to coordinate patient care and treatment, instruct/educate patients regarding their treatment protocols, medications, and required testing or procedures.

●Pre/post operative surgical teaching; surgery coordination

●Send cards for negative pregnancy (IVF) and graduation of pregnant patients who are going to OB/GYN

●Billing: Collect and post payments

●Answer telephone relay messages, place calls; interact with patients, families, visitors, staff and other departments in a professional manner

●Order Supplies / Inventory

●Coordinate appointments

●Take and Process Payments

●Manage schedule

●Effectively and efficiently manage the lobby

●Sort through correspondence

Borrego Health Foundation- Riverside CA August 2018 – January 2020 Referral Care Coordinator

●Data entry of all new referrals into the i2i referral module; documentation of all interventions to include, date and time.

●Documents necessary information pertaining to the referral order in the patient’s chart or EHR.

●Submits authorization to insurances, tracks the status of the authorization. Once approved, documents procedure approval number and authorization period in the referral tracking system.

●Responsible to track reports and to make sure that all reports are received in a timely manner. Close referrals once the report is received

●Collaborate with Care Coordinator Specialist to identify patients that could benefit from program enrollment due to their conditions or needs.

●Delivers care in accordance with established standard of care and accepted community standards.

●Understands the organizations commitment to provide high quality patient care. Promotes a Patient centered environment.

●Contribute to the success of the organization by participating in quality improvement activities.

UCI Healthcare - Orange, CA October 2012- December 2014

Principle Admitting Clerk/ Transfers Department/Unit Secretary

●Provide clerical support to a specific care unit

●Coordinate and maintain PAR levels for all supplies

●Answer telephone relay messages, place calls; interact with patients, families, visitors, staff and other departments in a professional manner

●Transcribe physician's orders accurately and alert nurses to new orders, single orders, and stat medications. Make sure Registered Nurse signs all orders.

●Answer patient call lights in timely manner and follow up with appropriate nursing personnel with patient needs

●Receive and relay messages with accuracy from other departments, e.g., Lab, X-ray, Admitting, etc. See that lab requisitions for patients are completed and sent to Lab

●Insurance verification

●Coordinate Transferring in patients

●Coordinate Conference calls between physicians

Contact this candidate