Elizabeth Ramos

• Prepare and lead monthly executive meetings with leadership and upper management to present audit findings, operational risks, and financial adjustment trends impacting multi-million-dollar accounts.
• Develop and manage over 30 customized Excel dashboards monthly, tracking audit outcomes, adjustment variances, and compliance metrics across Emergency, Outpatient, Oncology, Radiology, and additional departments.
• Lead Epic access and onboarding coordination, ensuring timely system provisioning for new hires through cross-functional collaboration with IT, department managers, and revenue cycle leadership.
• Analyze departmental audit trends to identify compliance risks, operational inefficiencies, and training needs; deliver targeted feedback and support corrective action planning.
• Create customized audit templates tailored for department leadership, ensuring each department’s specific auditing requirements are addressed and supported for consistent and accurate review.
• Serve as liaison between auditors, operational leadership, and IT teams to ensure seamless communication, issue escalation, and efficient problem resolution.

Investigated complex insurance denials across Medicaid, Medicare, and commercial carriers, drafting detailed appeals to overturn rejections and recover revenue.

Engaged with insurance providers to clarify benefits, secure timely resolutions, and advocate for proper claims reimbursement.

Managed extensive account lists through Excel tracking, maintaining compliance with internal KPIs and promoting accurate, proactive claims follow-up.

Collaborated with internal teams to identify claim discrepancies, support training improvements, and escalate recurring denial patterns for systemic correction.

Led account reconciliation initiatives, conducting eligibility audits and full-cycle AR reviews to resolve outstanding balances and denial claims.

Acted as a point of contact for cross-departmental billing issues, collaborating with clinical and administrative teams to streamline revenue cycle processes.

Oversaw daily payment posting, insurance appeals, and patient account adjustments with a focus on accuracy, timeliness, and compliance.

Coordinated daily revenue reporting and coding audits, ensuring timely charge capture and clean claim submissions.

Supported procedural coding accuracy and insurance verification for multiple departments, troubleshooting billing discrepancies and payer rejections.

Collaborated with management teams to monitor KPIs and address systemic billing challenges.

Led front-end insurance verification and appointment scheduling efforts, ensuring accurate revenue collection and billing preparedness.

Processed billing for over 400 patients weekly, supporting revenue generation and front office operational efficiency.

Partnered with billing supervisors to collect outstanding balances, educate patients on coverage, and streamline pre-authorization workflows.

Managed eligibility rejections and conducted detailed follow-up with insurance carriers to resolve payment disputes.

Increased hospital revenue by verifying patient insurance benefits, securing prior authorizations, and accurately coding services for reimbursement.

Served as a departmental billing resource, assisting team members with complex claim escalations and payer disputes.