DEVI RAM
Rio Linda,CA
Summary
A Dynamic and versatile leader with over ten years of Patient Access Care, Revenue Cycle, Patient Financial Experience and Management focusing on the referral management, patient eligibility, verification, and benefits. Subject matter expert in claims processing, payment posting, medical billing, and coding. Collaborate and bridge the gap between patient access, and financial management teams. Develop and recommend best practice recommendations. Organize and implement multi-workstream workflows in the care access space.
Overview
15
15
years of professional experience
Work History
Patient Financial Counselor
Sierra Nevada Memorial Hospital
11.2023 - Current
- Inpatient Audit, Labor & Delivery Condition of Admission, Financial Risk and Account Clearance in MS4 and Mede Analytics, Inpatient Notification to Veteran Affairs, Valuable & Discharges, Inpatient New Month Verification
- Casher, Therapies Preregistration, Outpatient Center for billing inquires, HPE, PCI Salucro Audits, FC Emails, CCS Report, FAAS
- Ambulatory & Radiation/Oncology Preregistration and financial Clearance
- Cardio & Surgery Preregistration, Cardiac Rehab and Respiratory Pre-registration, OB Pre-Registration
- PAI house task list, Pai None Reported, Work Comp, EFR, MS4 Reports
- Knowledge of health insurance regulations, policies & procedures for: Medi-Cal, Medicare, commercial insurance, managed care operations and workers compensation
- Ability of use of computers, including Cerner, Epic, Mede Analytics, AS400 and Allscripts applications, WEB based search engines, and other software programs, including Microsoft Office, i.e
- PowerPoint, Excel, and Access
- Able to request authorizations electronically for outpatient professional medical services via external websites/web-links, based on sensitivity to dealings with cultural and socioeconomic diversity
- Excellent problem solver with the ability to define, clarify, and set priorities for producing quality results
- SAP Predictive Analytics (SAP PA) is business intelligence software from SAP that is designed to enable organizations to analyze large data sets and run various descriptive and predictive analytical methods, and Tableau data visualization software
Patient Care—1500hrs for PA School
Colusa County IHSS
08.2021 - 01.2023
- Personal care assistant, including feeding, bathing, bowel and bladder care, dressing, medication, recording vital science, and assisting Licensed Physical Therapist
- Assisting with walking, following Physician’s orders, and health-related services
HIM Supervisor
Dignity Health
09.2022 - 09.2022
- Overall management and oversight of HIM health record processing-related services, including document-imaging, deficiency analysis, missing documentation, physician suspension, birth certificates, transcription, the release of information, QA, education, and training within the designated scope of responsibility
- Establish and monitor overall compliance to all related HIM KPIs and other metrics
- Leads large-scale projects, which include financial and quality analysis, problem-solving, and team collaboration while leading a multidisciplinary team to advance revenue cycle programs
- Proactively identifies opportunities, addresses obstacles, and leads transformational activities related to modernization and innovation
- Able to break down basic information and undefined problems into specific workable components that identify the issues at hand
- Logical conclusions and decisions using a solid data/analytical approach
- Consistently displays awareness and sensitivity to the needs of internal and external customers
Patient Access Consultant
Dignity Health (Robert Half Staffing)
05.2019 - 03.2020
- Assisted the organization with new system workflows that impacted the Patient Access and Financial Departments to increase benefits and revenue
- Counseling patients about their insurance benefits and advising alternative payment sources with financial assistance, providing government and private sector financial assistance programs for patients unable to meet their obligations
- Performs within the scope and training of the Emergency Room, and consistent State/ Federal regulations including EMTALA, HIPAA and other applicable regulations, including patient confidentiality and risk management
- Provision of competent patient care, for all ages, acuities, and conditions in the population the facility serves, including ensuring age-specific care and responding to cultural needs of patients and families
- Document patient care and unit activities in a timely, accurate, and concise manner
- Demonstrates an awareness of and sensitivity to patient/family rights, cultural and ethical beliefs
- Participates in ED staff meetings, in-services, and performance improvement activities
- Communicates clearly and with courtesy with all members of healthcare team, following lines of authority, as appropriate
- Providing training on capturing patient demographics, insurance plan eligibility, and benefits
- Collection of deductibles and copays before surgery and perform follow-up account activities to meet revenue goals
- Managing and evaluating team member performance; providing coaching, counseling, employee development, and recognition; ensuring ongoing training; and team building
- Collaborating with other teams with work related besides union issues
- Maintaining a working knowledge of applicable Federal, State, and local laws and regulations, Healthcare’s Integrity and Compliance Program, and Code of Conduct including, other policies and procedures to ensure adherence in a manner that reflects moral, ethical behaviors
- Working proactively with insurance and medical staff involved with a patient’s treatment plan to assist patients and their families in complete assistance program applications during processing and determining eligibility and coverage
Bank Reconciliation Analyst
Healthy Living (Robert Half Temp -Perm)
08.2018 - 05.2019
- Temporary was from 8/12017- 8/1/2018Company Hospice Facility closed due to COVID-19
- Posts cash receipts (e.g., checks, wires, electronic fund transfers (EFTs), credit cards, and tele checks) against related invoices, and balance cash posted within CPR+ back to bank totals
- Downloads lockbox images daily and monitor lockbox images for correspondence and missing explanation of benefits (EOBs)
- Populate monthly cash reconciliations for all cash received
- Oversees open MCDs and EDIs to ensure money is applied once invoice is available for posting and re-balance same day
- Pulls all EOBs from payer websites, ensuring all cash received has an associated EOB to post within a reasonable timeframe
- Imports 835s into ERN to facilitate auto posting
- Downloads all credit card charges to balance the bank deposit amount
- Works Unapplied Report twice a month to ensure all cash is applied to an invoice when available and reviews the zero-balance invoice report twice a month to move payments received to the patient invoice when available
- Supervises and trains staff on all posting job functions by dispersing cash to be posted, monitoring daily workflow and results, and providing feedback
- Assists with balancing batches as needed
- Performs month-end close to include but not limited to clearing all account errors, balancing post adjustments, executing all final month-end cash reports, and preparing month-end close secure to ensure all cash is in balance before billing closing their module
- Performs all testing related to cash posting during system upgrades
- Supports Collections and Billing teams in resolving client discrepancies regarding charges/invoices as needed
Lab Call Center Lead
Sutter Health
02.2016 - 08.2017
- Monitored overdue/pending/incomplete test reports, researched, resolved, and followed through on problem specimens or patient data problems per policies and procedures
- Completed and maintains laboratory worksheets, preventive maintenance logs, specimen logs, labels, and other records, as required
- Perform all the duties and responsibilities of an Outpatient Lab Assistant
- Assure that tests are performed properly, and results are verified before release; formulate, maintain, and review departmental procedures; coordinate the distribution and participation of proficiency testing, review results, take appropriate corrective action; maintain and monitor quality control programs; initiate and coordinate department and quality assurance plans; coordinate the preparation for all accreditation inspections, facilitate the inspection process, formulate corrective action as necessary; coordinate departmental equipment maintenance
- Assuring that all remedial actions are taken whenever test systems deviate from the laboratory established performance specifications as directed by the Director to ensure that patient test results are not reported until all corrective actions have been taken and the test system is properly functioning
- Monitor and assess pre-analytical and post-analytical systems and correct identified problems
- Assist the director with development and retaining competent professional satisfied staff: Recruit, interview, select, orient, provide training, coach, evaluate performance, recognize achievements; initiate, implement, and document all department continuing education events; counsel, discipline and terminate in accordance with state and Federal law; EEO guidelines and organizational policies
- Interact with department staff, with other Healthcare professionals and with other departments inside and outside the organization: Represent department and address issues through committee or taskforce meetings; act as liaison between management and staff, assist the staff in team building and participate in team building with own peer group; obtain information or services from vendors, consult with medical personnel regarding patient testing; work with other departments to resolve problems; collaborate with director(s), if appropriate and applicable, to resolve and respond to all concerns/complaints
- Completes the required laboratory orientation, training, and ongoing education as assigned
- Evaluates potential in new colleagues for hiring
Patient Access Supervisor
Sutter Health
10.2014 - 08.2015
- Insurance verification for eligibility, obtaining authorization for reimbursement for some high dollar accounts
- Research diagnosis and insurance benefits to receive a proper refund
- Perform internal quality audits to ensure all necessary documentation in each patient file
- Experience in HMO, PPO/POS, Tricare, and Medicare
- Experience in medical billing and medical terminology
- Follows up on unpaid accounts in patient accounting systems with the payers
- Works payer denials based on claim process adjudication; Review reports for possible underpayments; research contracts guidelines and resolve payment with the payer
- Perform appeals with the payer
- Perform bad debt request transfers as applicable
- Perform or requests adjustment and contractual write-offs or write up
- Reviews and resolves electronic acknowledgment payer rejections/denials
- Rebill claims as needed
- Work undistributed payment work list; Posts adjustments related to payments
- Maintain professionalism with various PFS staff, medical center staff, payers, and physicians
Patient Biller II -Denials Analyst
UC Davis Medical Center
10.2011 - 07.2012
- Insurance verification for eligibility, obtaining authorization for reimbursement for some accounts, Research diagnosis and insurance benefits to receive proper reimbursement
- Perform internal quality audits to ensure that all necessary documentation is included in each patient file
- Experience in health insurance concepts of HMO, PPO/POS, Tricare, and Medicare
- Experience in medical billing and medical terminology
- Follows up on unpaid accounts in patient accounting systems with the payers
- Works payer denials based on claim process adjudication; Review accounts for possible underpayments; research contracts, guidelines and resolve payment with payer
- Perform appeals with payer
Patient Financial Supervisor
Apria HealthCare
02.2010 - 10.2011
- Insurance verification for eligibility, obtaining authorization for reimbursement for some accounts, Research diagnosis and insurance benefits to receive proper reimbursement
- Perform internal quality audits to ensure that all necessary documentation is included in each patient file
- Experience in HMO, PPO/POS, Tricare, Medicaid, and Medicare billing and medical terminology
- Follows up on unpaid accounts in patient accounting systems with the payers
- Works payer denials based on claim process adjudication; Review accounts for possible underpayments; research contracts, guidelines and resolve payment with payer
- Perform appeals with payer
- Perform bad debt request transfers as applicable
- Perform or requests adjustment and contractual write offs or write up
- Reviews and resolves electronic acknowledgement payer rejections/denials; Rebills claims based on requests, rebill claim as needed
- Work undistributed payment work list; Posts adjustments related to payments
- Maintain professional communication with various PFS staff, medical center staff, payors, physicians, and patients regarding the billing of services rendered at Coram Infusion Specialty
- Handles patient calls and complaints, payer correspondence, or in person contact
Education
No Degree - Lean Six Sigma -Green Belt
University of California, Davis
Davis, CA03.2026
Master of Business administration - Health Services Administration
California State University Chico
05.2025
Bachelor of Science - Public Health, Community Health Education
California State University Sacramento
Sacramento, CA07.2021
Associate in science - General Science
Los Rios Community College
Sacramento, CA05.2018
Associate in arts - Social Science
Los Rios Community College
Sacramento, CA05.2018
Diploma - Phlebotomy, EKG Technician, Lab Assistant, Medical Assistant
National Career Education
Sacramento, CA01.2007
Skills
- Microsoft Office Suite
- Excel
- PowerPoint
- Words
- Outlook
- Publisher
- Access
- MS4
- EPIC
- Cerner
- Mede Analytics
- MedTech
- AS400 (iSeries)
Systemskills
- Microsoft Office Suite – Excel, PowerPoint, Words, Outlook, Publisher, Access
- MS4
- EPIC
- Cerner
- Mede Analytics
- MedTech
- AS400 (iSeries)
Timeline
Patient Financial Counselor
Sierra Nevada Memorial Hospital
11.2023 - Current
HIM Supervisor
Dignity Health
09.2022 - 09.2022
Patient Care—1500hrs for PA School
Colusa County IHSS
08.2021 - 01.2023
Patient Access Consultant
Dignity Health (Robert Half Staffing)
05.2019 - 03.2020
Bank Reconciliation Analyst
Healthy Living (Robert Half Temp -Perm)
08.2018 - 05.2019
Lab Call Center Lead
Sutter Health
02.2016 - 08.2017
Patient Access Supervisor
Sutter Health
10.2014 - 08.2015
Patient Biller II -Denials Analyst
UC Davis Medical Center
10.2011 - 07.2012
Patient Financial Supervisor
Apria HealthCare
02.2010 - 10.2011
No Degree - Lean Six Sigma -Green Belt
University of California, Davis
Master of Business administration - Health Services Administration
California State University Chico
Bachelor of Science - Public Health, Community Health Education
California State University Sacramento
Associate in science - General Science
Los Rios Community College
Associate in arts - Social Science
Los Rios Community College
Diploma - Phlebotomy, EKG Technician, Lab Assistant, Medical Assistant
National Career Education
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