Elena Elizabeth Ramirez
Lubbock,TX
Summary
Pursuing full-time role that presents professional challenges and leverages interpersonal skills, effective time management, and problem-solving expertise.
Overview
31
31
years of professional experience
Work History
Biologic Coordinator/ Surgical/Medical Assistant
Dermatology Associates of West Texas
Lubbock, TX
12.2022 - 06.2026
- Coordinate with medical providers, insurance carriers, specialty pharmacies, and imaging facilities to secure coverage and navigate through the prior authorization and appeals process.
- Identify patients within the organization who have been prescribed a biologic medication or scheduled for high tech imaging to start prior authorization process.
- Knowledge of both CPT and ICD-10 CODES, and prior authorization process for high tech imaging, procedures, and specialty medications.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
- Work along side provider in a high paced environment.
- Prepare equipment, and assist physician with medical treatments, exams, and surgical procedures, wound care instructions, removal of sutures, and bandage changes.
- Provide excellent patient/customer service on a daily basis.
Clinical Coordinator / Prior authorization Specialist
JUSTIN MCCARTHY MD PA
Lubbock, TX
06.2015 - 02.2022
- Supervised clinical staff, and clinical operations on a daily basis.
- Intercepted patient complaints to obtain facts, and find resolutions, prior to deferring to administrator.
- Managed employee/patient data via use of EMR system, Microsoft word, and excel
- Directed and coordinated medical and health services within the practice.
- Roomed patients, updated medical history, and obtained vital signs.
- Scheduled procedures/imaging as directed by providers.
- Liaison between specialty pharmacies, health insurance, and patients.
- Processed prior authorization requests efficiently, ensuring compliance with regulatory guidelines.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
- Contributed to a high level of customer service by quickly addressing questions or concerns from patients regarding their coverage or denials.
Clinical Manager
DR. NARENDRAN
Lubbock, TX
07.2005 - 11.2014
- Supervised, and guided, Clinical Staff.
- Led clinical operations to enhance patient care and streamline workflows
- Answered inquiries and provided information to the public, and/or patients, regarding activities/ procedures conducted by providers.
- Intercepted patient complaints, and obtained details to find solutions. Provided excellent customer service with a helpful, and friendly attitude.
- Trained junior staff on best practices in prior authorization procedures and system usage.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
CSR
B-WIRELESS
Lubbock, TX
06.2005 - 12.2005
- Conferred with customers by telephone or in person to provide information about products or services, take or enter orders, cancel accounts, or obtain details of complaints.
- Checked to ensure that appropriate changes were made to resolve customers' problems.
- Kept records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken.
- Resolved customers service or billing complaints.
- Completed contract forms, and prepared change of address records, using computers.
Unit Secretary
Covenant Medical Center
Lubbock, TX
10.1999 - 07.2001
- Managed multi line phone, and distributed calls to appropriate staff.
- Managed medical records and documentation, adhering to confidentiality standards and regulatory requirements.
- Assisted with communication between patients, families, and medical staff, enhancing overall patient experience.
Administrative Assistant
First Choice Home Health
Lubbock, TX
06.1995 - 03.1996
- Answered telephones and gave information to callers, took messages, or transferred calls to appropriate individuals.
- Greeted visitors or callers and handled their inquiries or directed them to the appropriate persons according to their needs.
- Created, maintained, and entered information into databases.
- Used computers for various applications, such as database management or word processing.
- Operated office equipment, such as fax machines, copiers, or phone systems and arranged for repairs when equipment malfunctioned.
Office Manager / Sales Clerk
Bigham Insurance Agency
Lubbock, TX
06.1995 - 03.1996
- Directed and coordinated activities involving sales. Resolved customer complaints regarding sales and service.
- Reviewed operational records and reports to project sales and determine profitability.
Education
Medical Office Specialist -
International Business College
Lubbock, TX06-2000
Vocational School Certificate - Medical
South Plains College
Lubbock, TXHigh School Diploma - undefined
Frenship High School
Wolfforth, TXSkills
- Leadership/Management experience
- Communication skills, Critical Thinking Organization / Time Management
- Computer-knowledge of Microsoft Word/Excel/ E-clinical Scheduling
- Prior authorizations (Procedures/High Tech Imaging/ Prescriptions
- Fluent in Spanish
- Excellent Customer Service
Timeline
Biologic Coordinator/ Surgical/Medical Assistant
Dermatology Associates of West Texas
12.2022 - 06.2026
Clinical Coordinator / Prior authorization Specialist
JUSTIN MCCARTHY MD PA
06.2015 - 02.2022
Clinical Manager
DR. NARENDRAN
07.2005 - 11.2014
CSR
B-WIRELESS
06.2005 - 12.2005
Unit Secretary
Covenant Medical Center
10.1999 - 07.2001
Administrative Assistant
First Choice Home Health
06.1995 - 03.1996
Office Manager / Sales Clerk
Bigham Insurance Agency
06.1995 - 03.1996
High School Diploma - undefined
Frenship High School
Vocational School Certificate - Medical
South Plains College
Medical Office Specialist -
International Business College