Diane Ramos
Fresno,CA
Summary
Former supervisor and educator, bringing over a decade of experience in managed care and Medicare. An ardent advocate, my knowledge spans benefits, group plans, medical coding, and the intricate landscape of health insurance. Actively seeking a full-time role where I can leverage my expertise, interpersonal skills, and problem-solving acumen, to drive ongoing success.
Overview
28
28
years of professional experience
Work History
Benefits and Transparency Advocate
CNO Financial Group, LLC
Fresno, CA
07.2022 - 04.2023
- Healthcare plan advisor and advocate
- Benefits education expertise
- Claim resolution specialist
- Proficient in cost efficiency- finding lower-cost healthcare options for members
Healthcare and Medical Coding Instructor
UEI College
Fresno, CA
11.2010 - 08.2013
- Engaging lectures and presentation
- Student assessment and development
- Provided resources and support to ensure student success
- Innovative teaching methods
Medicare Operations Supervisor
Aetna Health Plans
Fresno, CA
06.2000 - 12.2008
- Leadership and compliance specialist
- Regulatory policy development
- Recruitment and staff development
- HR adherence
- Problem solving expertise
- Demonstrates a deep understanding of HR policies and procedures
- Stakeholder relationship building
Business Information Specialist
Aenta Health Plans
Fresno , CA
04.1999 - 06.2000
- Medicare subject matter expertise
- Medicare compliance auditing for claims
- Daily review of Medicare member denials
- Cross-departmental collaboration
Claims Benefit Analyst
Aetna Health Plans
Fresno, CA
06.1995 - 03.1999
- Operations support specialist and point of contact person
- Provided claim processing, auditing, and training support
- Strategic development
- Daily monitoring and reporting
Education
Bachelor of Science - Sociology And Behavioral Science
Arizona State University
Tempe, AZ05.2024
Associate of Arts - Sociology
Fresno City College
Fresno, CA05.2020
Skills
- Claims and Calls management
- Effective communication
- Analytical and critical thinking
- Project leadership
- Medical terminology and coding
- Medicare regulatory expertise
- Claim Auditing
- Training and development
- Adaptability
- Microsoft proficient
Accomplishments
"2012 Best of the Best Educator Award"
Timeline
Benefits and Transparency Advocate
CNO Financial Group, LLC
07.2022 - 04.2023
Healthcare and Medical Coding Instructor
UEI College
11.2010 - 08.2013
Medicare Operations Supervisor
Aetna Health Plans
06.2000 - 12.2008
Business Information Specialist
Aenta Health Plans
04.1999 - 06.2000
Claims Benefit Analyst
Aetna Health Plans
06.1995 - 03.1999
Bachelor of Science - Sociology And Behavioral Science
Arizona State University
Associate of Arts - Sociology
Fresno City College
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