Summary
Overview
Work History
Education
Skills
Certification
Languages
Timeline
Generic

Daniel Ramos

Smyrna,GA

Summary

Reliable customer service professional motivated to maintain customer satisfaction and contribute to company success. History managing large amounts of inbound, outbound calls and emails sustaining satisfactory relationships with customers and company clients in a health insurance setting. Offers skill with CRM systems paired with outstanding active listening and multitasking abilities.

Overview

11
11
years of professional experience
1
1
Certification

Work History

Medical Coder

GMMI Inc
Pembroke Pines, FL
06.2023 - Current
  • Processed and coded provider claims according to policy guidelines Worked with team to translate provider claims in order to code and process for provider and member reimbursement
  • Coded 55-60 claims per day as per company KPI
  • Reviewed claims to ensure the treatments and services rendered were covered as per policy guidelines and treatment charges were reasonable.
  • Reviewed patient medical records for accuracy, completeness and compliance with coding regulations.

Client Service Coordinator

GMMI Inc
Pembroke Pines, FL
12.2022 - 06.2023
  • Able to work closely as a team with different departments within the company to ensure customer satisfaction.
  • Personalized client experience, identifying unique needs and providing information and services to match.
  • Followed up with customers through calls and emails to proactively resolve issues and maintain satisfaction.
  • Ensuring provider claims were processed and paid in a timely manner, maintaining good relationship with provider.
  • Review that all member inquiries such as provider statement, treatment pre-authorization and medical records are handled in a timely manner
  • Posted case handling fees for company revenue.

Network Manager

GMMI Inc
Pembroke Pines, FL
04.2022 - 12.2022
  • Worked to expand GMMI medical network in Latin America
  • Contacted providers nominated by client in efforts to expand medical network and provided weekly updates on progress
  • I was able to expand companies Latin American provider Network by contracting 11 additional hospitals/physician
  • Worked closely with other departments, (Client Service Coordinator, Claims, Assistance Department.) to resolve provider inquiries to maintain good relationship with provider.
  • Reviewed company and provider contracts, reviewed legal documents, and ensured compliance with organizational standards.

Client Service Coordinator

GMMI Inc
Pembroke Pines, FL
05.2015 - 04.2022
  • Able to work closely as a team with different departments within the company to ensure customer satisfaction.
  • Personalized client experience, identifying unique needs and providing information and services to match.
  • Followed up with customers through calls and emails to proactively resolve issues and maintain satisfaction.
  • Ensuring provider claims were processed and paid in a timely manner, maintaining good relationship with provider.
  • Review that all member inquiries such as provider statement, treatment pre-authorization and medical records are handled in a timely manner
  • Posted case handling fees for company revenue.

Order Picker

Jamaica Aerospace Company
Miramar, FL
05.2014 - 05.2015
  • Participate with the inventory count process utilizing handheld electronic devices Process outgoing shipments by locating the proper bins, picking the inventory, and deliver to shipping department Prepare special shipments by shrink wrapping and placing in the delivery vehicles

Call Center Customer Service Representative

GMMI Inc
Pembroke Pines, FL
08.2013 - 04.2014
  • Answered incoming calls from customers and provided assistance with product inquiries, billing questions, and other customer service related issues.
  • Resolved customer complaints in a timely manner to ensure customer satisfaction.
  • Maintained high levels of professionalism while interacting with customers via phone or email.
  • Managed incoming calls from patients and other healthcare facilities to provide information or schedule services.
  • Assisted in checking patient's insurance eligibility prior to their appointment.
  • Scheduled and confirmed patient appointments with patients and healthcare professionals.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.

Education

Luis Llorens Torres High School
01.2011

Skills

  • Courteous Demeanor
  • Microsoft Office Expertise
  • Adaptive Team Player
  • Multi-Task Management
  • Problem-Solving Abilities
  • Customer Support

Certification

AAPC CPC Certification / Certified Professional Coder

Languages

English
Native/ Bilingual
Spanish
Native/ Bilingual

Timeline

Medical Coder

GMMI Inc
06.2023 - Current

Client Service Coordinator

GMMI Inc
12.2022 - 06.2023

Network Manager

GMMI Inc
04.2022 - 12.2022

Client Service Coordinator

GMMI Inc
05.2015 - 04.2022

Order Picker

Jamaica Aerospace Company
05.2014 - 05.2015

Call Center Customer Service Representative

GMMI Inc
08.2013 - 04.2014

Luis Llorens Torres High School

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