Karla Ramos
Orange,CA
Summary
Motivated Patient Account Representative offering 25 years of healthcare and customer service experience. Highly effective time management, conflict resolution, and communication skills.
Overview
16
16
years of professional experience
Work History
Revenue Cycle / Patient Account Specialist III
Kaiser Permanente
04.2023 - Current
- .Uphold KP's Policies & Procedures, Principles of Responsibilities & applicable state, federal & local laws
- Tracks and analyzes monthly reports such as budget, operation activity, and department metrics; consolidates and analyzes trends and variances
- Assess claims for various lines of business, including, but not limited to, Medicare, Medi-Cal USDOL, State Workers' Compensation, third-party lien, self-pay, and DHMO
- Identifies effectiveness and improvement opportunities on various revenue cycle functions and processes
- Maintain timely capture and completion of audit data collection
- Partner with crucial stakeholder departments to meet annual goals and objectives
- Participates in various special projects
- Coordinates project work schedules to meet expectations and raises conflicting deadlines to management's attention
- Performs auditing functions within Revenue Cycle Operations, Patient Access, and CSS Departments
- Provide complex administrative and project support to department head and senior management using advanced MS Office skills (Word, Excel, MS Project, Visio, Access, and/or PowerPoint)
- Proofread content for accuracy and KP-established formatting
- Strong quantitative and analytical skills
- Ability to manage multiple priorities, work in complex, fast-paced work environments, be self-directed, detail-oriented, deadline-focused, flexible, and communicate effectively at all organizational levels.
- Collaborate with cross-functional teams to achieve project goals on time and within budget
- Implement new training programs for staff, leading to higher employee retention rates and better overall performance
- Enhance team productivity by streamlining processes and implementing time-saving strategies
- Develop strong relationships through consistent communication and attentive service.
- Oversee daily operations of busy office environment, ensuring tasks are completed efficiently and accurately.
- Assists with staff training to enforce quality, safety, and sanitation guidelines
- Manage inventory control, ensuring optimal levels of stock while minimizing waste and costs.
Financial Counselor
Kaiser Permanente
04.2018 - 04.2023
- Upheld KP's Policies & Procedures, Principles of Responsibilities & applicable state, federal & local laws
- Trained and mentored new Financial Counselors and Admitting Clerks
- Confidentially obtained reviews & records patient financial & demographic information
- Coordinated with/ inpatient/outpatient admission & registration to identify potential alternate payor sources
- Completed Medical Financial Assistance applications based on analysis of patient financial information
- Provided functional guidance to support staff & informed support staff & physicians on new and revised processes
- Retrospectively reviewed diagnosis & treatment records to identify potential Third-Party Liability & Worker's Compensation cases
- Placed telephone calls to appropriate departments (CSC, Sales & Marketing, etc.) in cases where group eligibility is not updated
- Contacted insurance providers to obtain critical information regarding patient benefits and submit account documentation
- Identified healthcare resources and programs for patients unable to meet financial obligations
- Conducted interviews with patients and family members and answered questions regarding insurance benefits
- Documented details regarding contact with patients, providers, and other individuals in HealthConnect
- Worked flexible hours, night, weekend, and holiday shifts
- Performed other related duties as required.
Admitting Clerk
Kaiser Permanente
04.2008 - 04.2018
- Obtained required information and made referrals to Financial Counseling as needed
- Reviewed accounts for coordination of benefits
- Performed pre-admissions functions for surgery and labor & delivery cases
- Secured and released patient valuables
- Verified patient details and insurance coverage and collected co-pays
- Handled admission processes and discharge procedures to transfer patients from hospital to home care, extended facility, and self-care plans
- Reviewed hospital schedule and confirmed arrival times
- Answered telephone calls to offer office information, answered questions, and made direct calls to staff
- Streamlined patient admissions process by implementing efficient data entry and record-keeping procedures
- Enhanced patient satisfaction with timely and accurate registration of personal information and insurance details
- Reduced wait times for patients by efficiently managing high-volume admission periods during peak hours
- Collaborated with medical staff to ensure seamless communication regarding patient status and bed availability
- Provided exceptional customer service, addressing patient concerns promptly and professionally
- Maintained strict confidentiality of sensitive patient information in accordance with HIPAA regulations
- Worked flexible hours, night, weekend, and holiday shifts.
Education
MBA - Business Administration
DeVry University
Chicago, IL02.2025
Bachelor of Science - Business/Healthcare Management
DeVry University
Chicago, IL02.2024
High School Diploma -
Saddleback High School
Santa Ana, CA06.2002
Skills
- Administrative and Office Support
- Database Search and Data Entry Skills
- Reliability and Dedication
- Computer Proficiency
- Performance monitoring
- Attention to detail
- Conflict resolution
- Records Management
- Process improvement
- Team Collaboration
- Mentoring abilities
- HIPAA Compliance
- Verbal and written communication
Timeline
Revenue Cycle / Patient Account Specialist III
Kaiser Permanente
04.2023 - Current
Financial Counselor
Kaiser Permanente
04.2018 - 04.2023
Admitting Clerk
Kaiser Permanente
04.2008 - 04.2018
MBA - Business Administration
DeVry University
Bachelor of Science - Business/Healthcare Management
DeVry University
High School Diploma -
Saddleback High School
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