Ramona A. Bristo

Work History

Superior Health Plan Inc

04.2023 - Current

Collaborated with other program coordinators to achieve consistency in program objectives and services.
Kept program-related data accurate, up-to-date, and easily accessible for accessibility.
Skilled at working independently and collaboratively in a team environment.
Managed over 50 member calls per day to complete all tasks within deadlines.
Excellent communication skills, both verbal and written.
Strengthened communication skills through regular interactions with others.
Verified insurance eligibility and coverage for patients.
Entered patient demographic and insurance data into an electronic medical record system.
Collaborated with various teams to uncover issues, identify applicable solutions, and offer guidance

Livanta

05.2021 - 03.2023

Answered patient questions and fielded complaints to resolve issues
Accessed patient information through various software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations
Documented and managed patient information in computer system
Resolved customer complaints or answered customers' questions
Delivered high-quality customer service through deep commitment to knowledge and performance
Answered multi-line telephone system and routed calls to appropriate personnel
Performed data entry and recordkeeping tasks to track company correspondence and updates
Delivered fast, friendly and knowledgeable service for routine questions and service complaints
Answered incoming calls and provided highest level of professionalism and knowledgeable service to every customer
Managed customer expectations by clarifying needs, identifying options and recommending products and services
Met or exceeded call speed, accuracy and volume benchmarks on consistent basis
Provided helpful assistance by anticipating and responding to needs of patients and family members
Obtained proper authorization and identification to release confidential medical records
Utilized technology and specialized software to maximize productivity.

CVS Healthcare

02.2019 - 05.2021

Handled new enrollments by entering customers' data and reviewing information
Working incoming cases via phone (primarily) or fax to process coverage requests from members or prescribers
Conducting outreach to patients and providers, and obtaining additional information needed to process requests
Researching and correcting any issues found in the overall process
Raising issues to Coverage Determination Clinical Pharmacists and Management team as needed
Reading, analyzing, and interpreting general business correspondence, technical procedures, and governmental regulations
Solving practical problems and dealing with multiple concrete variables in standardized situations
Performing basic mathematical calculations
Ensuring all cases are properly closed
Ability to interpret a variety of work instructions provided through multiple mediums
Ability to anticipate needs and resolve issues with urgency and to meet quality and production standards
Schedule flexibility including rotations through Nights, Saturdays, and minimal Holiday Coverage

Big Luthas BBQ & Catering

01.2014 - 02.2019

Scheduled and booked reservations, managed transportation, and secured venues for events with participants
Solicited potential event sponsors and coordinated event planning
Collaborated with sponsors and hosts to promote events
Oversaw event logistics, venue scheduling, and accommodations
Maintained close communication with clients to mitigate service issues
Directed event production in collaboration with sponsors, hosts, and internal teams
Organized corporate luncheons, dinners, conferences, and special events.
Coordinated schedules and timelines for events