Kathryn Ramirez
Hayward,CA
Summary
Experienced Senior Reimbursement Specialist excelling in denial resolution and healthcare reimbursement. Proven track record in optimizing billing workflows and enhancing team collaboration. Offering 10 years of experience and willingness to take on any challenge.
Overview
10
10
years of professional experience
Work History
Senior Reimbursement Specialist
Guardant Health
Palo Alto, CA
04.2022 - Current
- Analyzed reimbursement claims to ensure compliance with payer policies and regulations.
- Developed training materials to enhance team knowledge on reimbursement processes and systems.
- Collaborated with cross-functional teams to streamline billing workflows and improve claim accuracy.
- Monitored reimbursement trends and identified opportunities for process improvement initiatives.
- Mentored junior specialists, fostering skills in reimbursement procedures and best practices.
- Managed over 50 accounts each day to ensure the billing was submitted appropriately while also averaging 10 calls per day.
Reimbursement Specialist I/II
Guardant Health
Palo Alto, CA
07.2016 - 04.2022
- Processed reimbursement claims efficiently, ensuring compliance with internal policies and industry regulations.
- Collaborated with cross-functional teams to improve reimbursement workflows and enhance operational efficiency.
- Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
- Maintained patient confidentiality by adhering to strict HIPAA guidelines when handling sensitive information.
- Ensured timely payment of claims by promptly addressing and resolving any discrepancies or issues with insurance providers.
- Analyzed patient data to identify billing discrepancies, improving accuracy in reimbursement processes.
- Contributed to increased team productivity by consistently meeting or exceeding individual processing goals.
Missing Information Specialist
Natera
Redwood City, CA
11.2015 - 07.2016
- Used database to research, gather, analyze and present data.
- Resolved customer problems and complaints.
- Verified patients demographic information that coincided with their insurance information.
- Called clinics to get the names of ordering physicians and their NPI numbers if they were missing from the file.
Education
Bachelor of Science - Health Sciences (Pre-clinical)
California State University, East Bay
Hayward, CAMaster of Science - Healthcare Administration
California State University, East Bay
Hayward, CA05-2025
Skills
- Denial resolution
- HIPAA compliance
- Insurance verification
- Appeals processing
- Microsoft office
- Eligibility verification
- Teamwork and collaboration
- Attention to detail
- Basic knowledge of LEAN
- Healthcare reimbursement
Timeline
Senior Reimbursement Specialist
Guardant Health
04.2022 - Current
Reimbursement Specialist I/II
Guardant Health
07.2016 - 04.2022
Missing Information Specialist
Natera
11.2015 - 07.2016
Bachelor of Science - Health Sciences (Pre-clinical)
California State University, East Bay
Master of Science - Healthcare Administration
California State University, East Bay