ALICIA RAMIREZ
Ripon,CA
Summary
Patient-focused professional equipped with health administrative and customer service expertise. Helps keep healthcare services proceeding smoothly by coordinating communications, referrals, and policy enforcement. Talented in finding balanced solutions and resolving conflicts.
Overview
17
17
years of professional experience
Work History
Patient Financial Counselor
Stanford Healthcare Tri-Valley
05.2022 - Current
- Obtained information with third party payers to coordinate appropriate billing
- Collects insurance referrals and documents within EPIC.
- Communicate with patients and physician offices regarding authorization/referral requirements.
- Obtains financial responsibility data from patients as necessary.
- Informed clients in a timely manner of all approvals and denials, coverages.
- Screened incoming telephone calls, provided wayfinding services, and answered any patient inquiries.
- Maintained knowledge of current health care regulations related to billing practices.
- Advocated for patient rights when dealing with third-party payers.
Patient Advocate
Elevate
03.2020 - 05.2022
- Coordinate communication between patients, family members, clinical staff, and insurance companies.
- Screen self-pay patients admitted to assigned medical centers for all state-sponsored government programs, like medical.
- Completed comprehensive financial review of patient assets, property, and income to determine program eligibility.
- Created reports summarizing cases handled by the Patient Advocacy Department daily.
- Met regularly with department managers to review procedures and protocols related to patient advocacy.
- Assisted with the completion of insurance paperwork for patient coverage.
Patient Financial Counselor
The OutSource Group
04.2014 - 12.2016
- Provided patient eligibility access services
- Screened self-pay patients admitted to assigned medical center for all state sponsored government programs (including: Medical, CCS, MIA, MAP, CMSP, TPL, VOC, and other county/state programs
- Conducted comprehensive health care/ disability reviews to determine eligibility for Federal/State sponsored disability programs
- Provided pertinent documents associated with state Social Security disability processes
- Collaborated with multidisciplinary care teams including: Patient Access, Social Work, Case Management, Clinical teams and Discharge planning
- Provided patient eligibility information to care teams to assist in facilitating patient discharge planning
- Communicated with external medical staff in providing financial counseling services for externally transferred patients.
Emmanuel Medical Center
01.2008 - 01.2013
- Verified patient demographics and insurance information
- Ran insurance eligibility, assisted in collecting patient co-pays and collaborated with billing representative in processing outstanding balances
- Collaborated with external hospital staff in assigning patient's transfer of care
- Screened patients' insurance eligibility and assisted in linking patients to county/state programs including: Medical, CCS, MIA, MAP, CMSP, TPL, and VOC.
Education
HS Diploma -
Sistema Educatvio National
Some College (No Degree) -
Regional Occupational Program (ROP)
Skills
- Microsoft Office Programs (Excel, Word, Powerpoint, Outlook)
- HIPAA Compliance
- Medicaid knowledge
- Financial modeling and reporting
- EPIC Healthcare Software
- Microsoft Office Programs
- Charting and clinical documentation
- Referral Coordination
- Claims Processing
- Medical Billing
- Payment Processing
- Teamwork and Collaboration
Timeline
Patient Financial Counselor
Stanford Healthcare Tri-Valley
05.2022 - Current
Patient Advocate
Elevate
03.2020 - 05.2022
Patient Financial Counselor
The OutSource Group
04.2014 - 12.2016
Emmanuel Medical Center
01.2008 - 01.2013
HS Diploma -
Sistema Educatvio National
Some College (No Degree) -
Regional Occupational Program (ROP)
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