Ramona Taylor
Tyler,TX
Summary
Dedicated administrative professional well-versed in communication and team building. Knowledgeable in healthcare for STAR Kids/STAR/CHIP. Ready to bring 14+ years of relevant work experience to the team.
Overview
32
32
years of professional experience
1
1
Certification
Work History
Member Advocate
Texas Children's Health Plan
01.2021 - 05.2024
- Provides member support and advocacy
- Educates members about their rights and responsibilities, which includes complaints and appeals process
- Advocates for members during complaints, appeals, and fear hearings; complies all necessary information to ensure appropriate Member representation
- Solves problems proactively and provides timely resolution to complex issues
- Identifies most appropriate course of action for problem resolution and effectively communicates plans to those impacted
- These issues frequently require research, collaboration with other departments, communications with external resources, and response creation
- Handles difficult callers; provides timely assistance and intervention with problem calls
- Addresses challenging customers and problems that require escalation outside the department
- Monitors real-time queue and adherence reports to ensure service level and response time objectives are met; oversee real time escalation plans
- Conducts group training sessions and the dissemination of information to team members
- Collaborates with Claims, Eligibility, Provider Relations, Business Operations and other Health Plan departments as needed to resolve member and/or provider issues
- Supports initial and ongoing system training
- Responds to internal system trouble notifications and, if necessary, coordinates the involvement of other departments to facilitate problem resolution
- Serves as a continual resource for team member questions, concerns, etc.; viewed as being a primary available and approachable resource to team members
- Fosters relationships amongst peers and internal departments to aid in collaborative discussions and workgroups to achieve business objectives; develops or refines processes and systems
- Facilitates meetings to share and encourage learning from each other
- Evaluates, monitors, and coordinates community resources
- Maintains current knowledge of local and state resources
- Coordinates with DARS and local resources for the identification and support of employment and training opportunities for members
- Identifies options and initiates collaboration with referral sources to ensure member/family linkage to specialists, homecare providers, financial assistance, housing, meals, transportation, and other community resources as appropriate for members with unmet needs
- Develops support systems to meet the members needs by identifying and coordinating a variety of available services based upon member needs and preference
- Participates in quality initiatives
- Assist manager in identifying opportunities for process and service improvement initiatives
- Participates in the development and implementation of action plans
- Conducts telephone based surveys regarding customer satisfaction
- Engages in one-on-one phone based member education and communications
- Counsels health plan members who are identified as non-compliant, make inappropriate use of health services, abusive, fail to keep scheduled appointments, etc
- Participates in special projects or other committees identified for the department
- Identifies trends and process opportunities based on customer contact that may require review and modification to the current workflow or creation of a new flow/ policy and procedure.
Administrative Assistant
Community Integration Project
10.2020 - 12.2020
- Provide administrative support to the Executive Director
- Maintain knowledge of HHSC state regulations with Medicaid
- Run errands
- Obtain information to assist with gaining state Medicaid contracts
- Create postcards with services provided to include therapy services, home health, etc
- Research needs in the community.
Coordinator Community Support
American Cancer Society
02.2006 - 09.2020
- Provides support to two Community Development Managers and one Distinguished Events Manager including, but not limited to Senior Managers/Directors and Volunteers of 7 Relay events, 5 Social events and 1 Cattle Barons' Gala's
- Office Support
- Provide office supply management, to include ordering, inventory, receiving orders, and expenses
- Responsible for materials/product management - receiving orders, maintaining inventory and distributing to appropriate staff
- Oversee mail management, coordinate receipt and distribution of letters, packages, correspondence, sort mail, process all office bulk mailings, maintain postage due accounts and postage in meters
- Provide support for facility management, interact with building management and landlord as needed, serve as a liaison for the Facilities Department for annual building inspections injury incident reports, office closure, security point of contact, local point of contact for internal/ external office vendors
- Provide general office operation support, coordinates office space utilization and equipment with regional facility manager; manages off site / internal storage facility clean up and maintains and manages inventory of fixed assets
- Process serfs for office related expenses and invoices
- Point of contact for meetings and training being held at the office location including AV equipment, conference rooms, office meetings and training (beverages, food, room preparation, supplies)
- Serve as a liaison for the IT department; works with them to receive/return needed equipment (i.e
- New hires/departures, event related needs, etc.), resolve office wide computer related issues, and acts as point of contact for computer and hardware upgrades and phone systems
- Oversee reception and front desk duties, receive incoming calls, provide assistance to callers; greets visitors and provide assistance as needed, maintain visitor sign-in log, ensure office is covered for opening and closures, and addresses general event and mission related inquiries from walk-ins
- Oversee office volunteer management and collaborates with the Volunteer Care Team to fulfill volunteer requests
- Oversees all income processing and cash management in accordance with Finance and internal audit procedures
- Manage local office Seibel service request activities and reassign as necessary Event Support
- Responsible for creating, preparing, proof-reading, and reviewing content and format for all events and related materials including but not limited to: invitations, RSVP's, brochures, posters, letters, programs, certificates, and name tags
- GALA EVENT SUPPORT
- Maintains records of orders ensuring appropriate accounting
- Provide event and material product support
- Set up and compile information for distinguished events including bid forms, bid paddles, and accurate seat assignments & charts within Greater Giving
- Order event related supplies including but not limited to: awards, brochures, apparel (as applicable), supplies, invitations, promotional products (gifts giveaways, etc.), t-shirts, luminaria, and incentive prizes
- Prepares event correspondence, team captain packets, sends invitations for kickoffs, registration nights, committee meetings and other events
- Manages RSVP process for event and event related meetings
- Maintains contact list for events
- Prepares mailings (lists, labels, stuffing, and sealing), bulk mail, mail merge, etc
- Provides general event support: maintain schedule of locations, dates and times for events
- Assist with event participant registration/ticket purchasing as needed, maintain insurance and contract process (certificates of insurance), act as point of contact for event related inquiries (SRS, phone, walk-ins), manage auction process (entering auction items, coordinate auction item; not to include soliciting auction items)
- Assists in proactive planning for distinguished events, including future needs of materials, copies, brochures, sponsor packets, etc., assist lead staff with training of registration and check out process, assist with clean-up of auction including refund of credit cards, wrong auction items, etc., work with lead staff to sync Greater Giving, assist lead staff with locating and updating pictures of all silent auction items, post event management activities, work with lead staff to keep auction inventory in a safe and in order, pack and send back Greater Giving terminals
- Maintain a small game of chance license
- Performs event data entry to include: income, expenses, sponsorship, etc
- Into Siebel, Event Management Tool (EMT), and Greater Giving
- Maintain and update records of committees, sponsors, survivors, etc., ensure post event data was entered into EMT accurately and timely
- Submits new and updated event data to SSBC when necessary
- Provides on day event support as approved and within policy
- Attend events to support staff and volunteers, help volunteers through registration and check out, help setup and take down the computers, printer, etc
- Provide support for onsite donation processing
- Provides support for event income processing (assist office support in the local office(s))
- Ensures proper preparation of batch headers, process donations, create bank night kits: batch forms, counting packets, log, bank bags, and income processing box
- Reconciles income and expenses in Lawson
- Pulls reports as needed to support ACS Distinguished & Community Events, reviews reports as needed, follows up on data quality or content concerns; compiles and summarizes data to meet specific account management needs
- Manages specific data (i.e., registrations, donations, previous YTD information, lapsed participants, team leader reports, etc.) Current knowledge of salesforce, netsuite, and marketplace.
Administrative Assistant
Texas Commission on Environmental Quality
07.2004 - 10.2004
- Prepared Permit by Rule letters and simple emissions, banking and trading letters
- Proofread letter for accuracy and completeness
- Prepared letter for mailing according to agency standards
- Organized, tracked, transmitted and maintained filing system
- Reviewed and entered tracking elements into IMS (Information Management System)
- Answered and screened telephone calls, provided information to basic questions
- Prepared and submitted production records and statistics for reporting and tracking work processed.
Route Driver
Schwan's Food Company
05.2000 - 07.2004
- Drove a commercial vehicle servicing existing customers on a bi-weekly route schedule which included money handling, establishing new customers within the Austin-Metro area
- Answered questions about new and existing products, promotions and discounts
- Assisted Facility Manager with training new hires and assisted routes while other employees were on leave
- Complied with DOT regulations.
Administrative Assistant IV
Texas Natural Resource Conservation Commission
03.1993 - 05.2001
- Performed complex technical administrative duties in the Air and Waste Applications Team
- This included working directly for the Director of Waste Management in keeping up with schedules, meetings and making travel arrangements
- Also made travel arrangements, processed reimbursements and processed payroll time for eight staff members
- Completed numerous projects dealing with permitted and non-permitted facilities
- Sorted and distributed mail to Engineers in the Air Permit Division
- Completed technical reviews of permit applications in order to prepare public notice packages if necessary
- Handled internal and external calls
- Maintained knowledge of State and Federal Rules and Regulations.
Data Entry Operator
Volt Temporaries
06.1992 - 03.1993
- Hired to work for the Texas Water Commission as a temporary employee in the Petroleum Storage Tank (PST)/Remediation Section
- Job functions included answering phones, assisting coordinators with mass mail outs, data entry of PST incident reports, assisting task force team with the 'Reasonable Cost Market Survey', typed correspondence, filing and other duties as assigned.
Education
Associates Degree - General Studies
Kilgore College
Kilgore, TX05.2019
High School Diploma -
John Tyler High School
Tyler, TX05.1987
Skills
- HIPAA Compliance
- Team Collaboration
- Information Collection
- Collaboration and Teamwork
- Documentation and Recordkeeping
- Supply Ordering
- Clerical Support
- Money Handling
- Patient Education
- Relationship Building
- Phone and Email Etiquette
- Eligibility Determination
- Critical Thinking
- CPR Certified
- Patient Health Information Access
- Inventory and Inventory Control
- Self-directed
- Administrative Support
- Skype
- Direct Support
- Service Desk
- Provider Search
- NetSuite
- Office Coordination
- Documentation Review
- Computer Proficiency
- Call Screening
- Regulatory Compliance
- Multitasking and Organization
- Organization and Time Management
- Customer Service
- Microsoft Office Suite
- Excel
- PowerPoint
- Outlook
- Data Entry
- Commercial Driving
- QNXT
- Vital
- Macess
- WellSky
- Connect
- Epic Systems
- Cross-cultural communication
- Assertiveness
- Problem-Solving
- Basic Life Support for Health Care Providers (BLS)
- Heartsaver First Aid CPR AED (First Aid CPR AED)
Certification
- BLS Certified, 2/2026
- Notary Public of Texas, 6/2027
Timeline
Member Advocate
Texas Children's Health Plan
01.2021 - 05.2024
Administrative Assistant
Community Integration Project
10.2020 - 12.2020
Coordinator Community Support
American Cancer Society
02.2006 - 09.2020
Administrative Assistant
Texas Commission on Environmental Quality
07.2004 - 10.2004
Route Driver
Schwan's Food Company
05.2000 - 07.2004
Administrative Assistant IV
Texas Natural Resource Conservation Commission
03.1993 - 05.2001
Data Entry Operator
Volt Temporaries
06.1992 - 03.1993
Associates Degree - General Studies
Kilgore College
High School Diploma -
John Tyler High School
Similar Profiles
Erika BlountErika Blount
Patient Access Specialist at Texas Children's Health Plan ClinicPatient Access Specialist at Texas Children's Health Plan Clinic
Alicia RodneyAlicia Rodney
Customer Service Representative Provider Services at Texas Children's Health PlanCustomer Service Representative Provider Services at Texas Children's Health Plan
Huong DaoHuong Dao
Claims Benefits Specialist at Texas Children's Health PlanClaims Benefits Specialist at Texas Children's Health Plan
Amber KaiserAmber Kaiser
TCHP Service Coordinator at Texas Children's Health PlanTCHP Service Coordinator at Texas Children's Health Plan
Akayla ManningAkayla Manning
Sales Associate, Cashier at Raquet and Jog- TylerSales Associate, Cashier at Raquet and Jog- Tyler