DAMARIS RAMOS
PENFIELD,NY
Summary
Professional with strong background in customer interactions and service solutions. Highly skilled in conflict resolution, communication, and problem-solving, ensuring customer satisfaction and loyalty. Effective team collaborator, adaptable to changing needs, and consistently focused on achieving results through efficient and empathetic service. Known for reliability and proactive approach to meeting customer and organizational goals.
Overview
5
5
years of professional experience
Work History
Senior Care Program Support Coordinator
Fallon Community Health Plan Inc
07.2021 - 05.2025
- Processes short-term and long-term Authorizations for our members.
- Process authorizations for PCA, meal delivery, adult foster care, and adult day health services.
- Works on various types of reports using Excel.
- Prints and prepares letters to go out to the members.
- Uses TruCare and QNXT to perform daily tasks.
- Handled Call Tracking cases and escalated them as needed.
- Processes New Enrollments for new members coming into our insurance
- Developed training materials for new staff on best practices in support coordination.
- Worked with other departmental staff to answer questions and resolve problems.
Distribution Services Representative II
Fallon Community Health Plan Inc
08.2020 - 07.2021
- Processed Personal Representative Forms
- Processed PCP request forms.
- Used QNXT
- Worked handling Data Integrity
- Handled Call Tracking cases and escalated them as needed.
- Worked processing fulfillments as needed.
- Scanned documents into the Alchemy system to support the Claims and Enrollment departments.
Education
Associate of Science - Criminal Justice
Quinsigamond Community College
Worcester, MA05.2019
Skills
- Customer Relations (Experienced)
- Data Management (Expert)
- Spanish (Expert)
- Data Entry (Expert)
- Report Generation (Expert)
- QNXT (Expert)
- TruCare (Expert)
- Excel (Experienced)
- Authorization Processing (Expert)
- Conflict Resolution (Experienced)
- Time Management (Experienced)
- Critical Thinking (Experienced)
- Team Collaboration (Experienced)
- Report preparation
- Time management
- Attention to detail
- File organization
- Office administration
- Customer database systems
LANGUAGES
English (Native)
Spanish (Native)
Timeline
Senior Care Program Support Coordinator
Fallon Community Health Plan Inc
07.2021 - 05.2025
Distribution Services Representative II
Fallon Community Health Plan Inc
08.2020 - 07.2021
Associate of Science - Criminal Justice
Quinsigamond Community College
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