Kylie Ramirez
Albuquerque
Summary
Experienced customer service professional with healthcare industry experience supporting patients, providers, and insurance operations. Strong background in claims research, insurance verification, problem resolution, HIPAA compliance, and high volume call and chat environments. Skilled ar resolving complex inquiries while delivering exceptional customer service.
Overview
16
16
years of professional experience
Work History
Customer Service Representative Senior
United Healthcare
Albuquerque, NM
11.2024 - Current
- Assist healthcare providers with claims, eligibility, benefits, billing and authorization inquires
- Research and resolve complex claim and payment issues
- Interpret benefit plans, reimbursement guidelines, and coverage policies
- Maintain HIPAA compliance while handling sensitive information
- Collaborate with internal departments to resolve provider concerns efficiently
Customer Service Representative
Presbyterian Healthcare
Albuquerque, NM
06.2022 - 11.2024
- Ensured compliance with HIPAA regulations concerning patient privacy rights.
- Answered incoming calls and responded to customer inquiries in a timely manner.
- Educated patients on how to access online portals for scheduling appointments, making payments or viewing lab results.
- Provided accurate information regarding insurance coverage, billing and payment processing.
- Communicated effectively with various departments within the organization in order to resolve customer issues quickly.
Accounts Payable Assistant
Roses Southwest Papers
Albuquerque, NM
01.2020 - 06.2022
- Maintained organized filing systems for both paper and electronic documents.
- Responded to customer inquiries via phone, email, and in person.
- Provided administrative support such as filing documents, photocopying and scanning materials.
- Entered data into accounting system to maintain accurate financial records.
- Providing support to administrative staff with miscellaneous tasks as requested.
Table Games Dealer
Isleta Casino & Resort
Albuquerque, NM
03.2010 - 01.2020
- Provided friendly customer service to guests at the casino table games area.
- Utilized appropriate strategies when dealing specific games.
- Dealt table games such as Blackjack, Baccarat, and Roulette professionally and accurately.
- Collected losing bets and paid out winnings promptly and accurately.
- Performed functional game duties quickly by efficiently handling money and chips.
Education
Medical Billing And Coding Certificate -
Carrington College - Phoenix
Phoenix, AZ11.2023
High School Diploma -
Albuquerque Charter Vocational High School
Albuquerque, NM05.2007
Skills
- Medical terminology proficiency
- ICD-10 Coding
- Insurance Verification
- Patient Scheduling
- Call Routing
- Conflict resolution techniques
- HIPAA compliance
- Claims investigation
- Teamwork and collaboration
- Problem-solving skills
Timeline
Customer Service Representative Senior
United Healthcare
11.2024 - Current
Customer Service Representative
Presbyterian Healthcare
06.2022 - 11.2024
Accounts Payable Assistant
Roses Southwest Papers
01.2020 - 06.2022
Table Games Dealer
Isleta Casino & Resort
03.2010 - 01.2020
High School Diploma -
Albuquerque Charter Vocational High School
Medical Billing And Coding Certificate -
Carrington College - Phoenix