Mario Ramos
Kyle,TX
Summary
To succeed in an environment of growth and excellence and earn a job which provides me job satisfaction and self development and help me achieve personal as well as organization goals.
Overview
20
20
years of professional experience
Work History
Financial Screener I
Community Care
09.2019 - Current
- Under general supervision, explains available programs/services to applicants and through a screening process provides enrollment services and/or application assistance based on applicant’s eligibility
- Interview applicants to obtain appropriate personal information and additional data needed for application/enrollment in various programs
- Verify information obtained to ensure accuracy and evaluate information to determine whether eligibility is met for available healthcare programs
- Enroll applicants in programs determined eligible for
- Assist applicants with the completion and submission of required applications/forms
- Assess potential referral needs and direct applicants to services as needed, providing program information, benefits and services
- Maintain client files and enter accurate data into appropriate databases and/or software
- Participate in audits and reviews of eligibility determinations and client files
- Perform other duties as assigned.
- Complied with all federal, state, and local regulations as well as company rules.
Eligibility Specialist
Central Health
08.2018 - 09.2019
- Eligibility Specialist - Under general supervision, refers, enrolls and/or assists customers in obtaining appropriate healthcare, and assists customers in resolving complex problems and complaints
- I make decisions for multiple programs regarding a client’s eligibility for healthcare services including interpreting and applying complex program requirements
- I Explain program benefits and how to access services
- I assist customers in resolving complicated problems and complaints regarding services
- I apply performance standards to determine the accuracy of simple to complex program decisions
- I perform other duties as assigned such as Community Care referrals or Virtual Referrals.
- Enhanced client satisfaction by providing timely and accurate eligibility determination for various assistance programs.
- Reduced errors in eligibility determinations by maintaining thorough knowledge of program guidelines and regulations.
- Provided exceptional customer service through prompt response times, clear communication channels, and diligent follow-up practices.
Medical Billing Coordinator
United Medical Centers
04.2006 - 05.2017
- Billing Coordinator: Responsible for overseeing all electronic third party billing activities and claim review for 7 clinic sites
- Responsible for monitoring the medical practice management system to ensure that information is posted appropriately to produce billing reports for various grants, third party billing and the CFO to present to the Board of Directors
- Responsible for overseeing all processing and submitting of insurance claims for Medicare/Medicaid and Private Insurance
- Responsible for the coordination of all training of Business Office and Health Records personnel in data entry relating to all third party billing and grant billing requirements
- Assists the BO specialist in updating system files. -Head Cashier: Responsible for the collection process of all types of accounts and for performing cashiering functions
- Responsible for performing account receivable functions and maintaining appropriate records of daily transactions through the Center’s computer system
- Responsible for screening and assessing all patients to determine their financial status/needs in order to receive the service provided at United Medical Centers
- Also make corrections on daily reports. -Cashier: Responsible for screening all billing and posting activities of United Medical Centers
- Responsible for all cashing functions as per approved guidelines and protocols
- Responsible for the screening and assessing all patients in order to determine their financial eligibility for clinic services
- Responsible for utilizing the Primary Health Clinic (PHC) screening tool and automate Medicaid system document all applications electronically and refer patients to the appropriate programs in the community
- Responsible for providing information regarding United Medical Centers services to patients and the general public.
- Increased revenue collection by diligently following up on outstanding payments and negotiating payment plans with patients when necessary.
- Improved billing accuracy by implementing stringent quality control measures and enhancing documentation processes.
- Collaborated with insurance providers to expedite claims processing and secure timely payments for services rendered.
- Assisted in the implementation of new software systems designed to streamline billing processes, leading to increased accuracy and reduced administrative burden on staff members.
Substitute Teacher
Eagle Pass Independent School District
10.2005 - 04.2006
- Responsible to assigned work in the absence of a regular teacher to aid students in understanding a subject matter, as well as to provide skills required for programmed lessons and purposeful training for the classroom.
- Followed classroom plans left by class teacher to continue student education and reinforce core concepts.
- Upheld classroom routines to support student environments and maintain consistent schedules.
- Developed strong rapport with students through consistent encouragement and support, fostering a positive learning atmosphere conducive to academic growth.
- Kept students on-task with proactive behavior modification and positive reinforcement strategies.
- Maintained day-to-day classroom management and discipline to promote learning initiatives.
- Provided instruction for students in core subject areas.
Cashier
Wal-Mart
09.2004 - 09.2005
- Primary roles include scanning coupons, applying discounts, processing payments and ringing up sales on computerized cash registers
- Also take responsibility for handling returns and answering questions about merchandise, store policies, and ongoing promotions.
- Greeted customers entering store and responded promptly to customer needs.
- Welcomed customers and helped determine their needs.
- Worked flexible schedule and extra shifts to meet business needs.
- Operated cash register for cash, check, and credit card transactions with excellent accuracy levels.
- Helped customers complete purchases, locate items, and join reward programs.
Education
Associate of Science - Criminal Justice
Southwest Texas Junior College
Eagle Pass01.1998
High School Diploma -
Eagle Pass High School
Eagle Pass, TX01.1994
Skills
- Spanish - write, read, and speak
- Microsoft Word, Microsoft Excel, Microsoft PowerPoint, and WordPerfect
- Results management
- Analytical mindset
- Corporate Procedures
- Assertiveness
Timeline
Financial Screener I
Community Care
09.2019 - Current
Eligibility Specialist
Central Health
08.2018 - 09.2019
Medical Billing Coordinator
United Medical Centers
04.2006 - 05.2017
Substitute Teacher
Eagle Pass Independent School District
10.2005 - 04.2006
Cashier
Wal-Mart
09.2004 - 09.2005
Associate of Science - Criminal Justice
Southwest Texas Junior College
High School Diploma -
Eagle Pass High School