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Melissa Ramon
Bridgewater,MA
Summary
Dedicated professional with comprehensive experience in patient communication and scheduling within healthcare environments. Proven track record in streamlining order management processes, ensuring HIPAA compliance, and enhancing service delivery. Committed to delivering efficient, high-quality service that positively impacts patient experiences.
Overview
14
14
years of professional experience
Work History
Call Center Operator – Food Services Department
Brigham and Women's Hospital
Boston, MA
04.2019 - Current
- Works in the Food Services Department, specifically in the call center
- Answer food calls from patients all over the hospital.
- Communicated efficiently and respectfully with patients during high call volumes, facilitating meal service selections and accurately entering orders into the Competition system.
- Accompanied patients to ensure satisfaction with food services, confirming meal quality and addressing any concerns.
- Assisted in delivering meal trays to patients during busy shifts, ensuring timely service even with low kitchen staff.
- Communicated patient diet order issues to the Call Center Operator Lead, Diet Tech, or clinical dietician.
Central scheduling Radiology
New England Baptist Hospital
Boston, MA
07.2019 - 12.2022
- Prepared daily schedules for O.R., PAS, ENDO, and Radiology, ensuring accuracy and proper documentation.
- Scheduled outpatient appointments for all ancillary departments according to CSO protocol.
- Pre-registers all scheduled patients for pre-admission screening, inpatient and outpatient procedures according to department policies.
- Implemented HIPAA guidelines to ensure compliance in all administrative tasks
- Screened registrations for compliance with service utilization and adherence to Federal, State, and third-party managed care mandates.
- Assisted in continuing education for MDs and hospital personnel on insurance issues, serving as a consistent resource.
Revenue Cycle Associate (Hospital A/R Follow Up)
Steward Health Care Systems
Westwood, MA
05.2018 - 07.2019
- Executed collection activities to ensure timely resolution and reimbursement of claims.
- Ensure that all claims are billed and collected and meet all government mandated policies for Integrity and Compliance
- Resubmitted clean and accurate claims to insurance companies promptly and in compliance.
- Resolve complex claims processing issues with third party payers and provide all required information timely
- Researched, prepared, and submitted appeals to insurance companies for adverse determinations, advocating for proper claim outcomes.
- Monitored denials and trends, escalating significant issues to supervisor for prompt resolution.
- Collaborated with multiple departments to resolve accounts.
- Achieved departmental goals through strategic planning and execution.
Elder Service Plan Claim Specialist
East Boston Neighborhood Health Center
E. Boston, MA
07.2012 - 05.2018
- Delivered customer service by managing incoming and outbound calls, accurately documenting call details.
- Triaged calls and redirected to the appropriate staff.
- Data entry for billing claims along with ensuring the follow through of each claim entered from beginning to end
- Ensured accurate payment of claims in accordance with all contracts.
- Responsible for preparing and sending out checks for payment of external vendors
- Coordinated communication between departments and vendors to improve collaboration.
- Assist the Marketing Teams with outreaches to patients and their families
Education
High School Diploma -
West Roxbury High School
Boston, MA06-2007
Associate of Arts -
Massachusetts Bay Community College
Wellesley Hills, MASkills
- Customer service
- Order management
- Patient communication
- HIPAA compliance
- Data entry accuracy
- Schedule coordination
- Problem solving
- Attention to detail
Languages
Fluent in English and Spanish
Timeline
Central scheduling Radiology
New England Baptist Hospital
07.2019 - 12.2022
Call Center Operator – Food Services Department
Brigham and Women's Hospital
04.2019 - Current
Revenue Cycle Associate (Hospital A/R Follow Up)
Steward Health Care Systems
05.2018 - 07.2019
Elder Service Plan Claim Specialist
East Boston Neighborhood Health Center
07.2012 - 05.2018
High School Diploma -
West Roxbury High School
Associate of Arts -
Massachusetts Bay Community College