Ana Ramos has over 15 years of experience in healthcare finance and operations management. She currently works as the Finance Manager at Brigham and Women's Hospital - Southern Jamaica Plain Health Center, where she oversees a team that assists patients with insurance, billing, and prior authorizations. Previously, she held management roles at Partners Healthcare and other organizations, supervising staff and coordinating referrals, claims, and other managed care processes. Ramos has extensive knowledge of healthcare software systems and payer requirements. She aims to provide excellent customer service while ensuring deadlines and responsibilities are met.

1. ANA RAMOS
69 Deering Road, Mattapan, MA 02126 617-435-3591 ana.ramos478@gmail.com
QUALIFICATIONS
 Leader and motivator
 Ability to work in a high pressure fast
paced environment
 Quick learner
 Strong interpersonal, organizational and
communication skills
 Extensive knowledge of all facets of
Managed Care Services, Microsoft
Software, Apple Software,3rd
Party
Billing, Claims,and Prior Authorization
Requirements
 Demonstrated ability to manage,
prioritize, organize and meet deadlines
 Effective problem solving, team building
and training skills
 Experienced with BICS, IDX, LMR
NOAH and Percipio hospital based
systems.
 Skilled with Blue links, Emdeon, Health
trio, MMIS, Nehen Express, AIM and
NIA payer tools
 EPIC Super User
EXPERIENCE
BRIGHAM AND WOMENS’ HOSPITAL- Southern Jamaica Plain Health Ctr. Jamaica Plain, MA
Finance Manager/Managed Care 09/12-Present
 Provide supervisory oversight, support and guidance to a team of four Financial Counselors.
 Works collaboratively with patients, providers, case manager and community outreach workers to
assist patients with financial assistance, by providing Mass Health, Health Safety Net,
financial/insurance information and application assistance.
 Responsible for processing prior authorizations for medications as well as radiology procedures and
exams.
 Supervise the daily Referral and Pre-Registration process
 Responsibilities include creating and implementing work flows and best practices for functions
including registration, managed care referrals, insurance verification, prior authorizations for both
radiology and specialist appointments
 Responsible for customer service to patients/providers/specialists/payers in a private manner.
 Monitors outstanding balances and maintains consistent follow-up to ensure patients resolve
outstanding balances
 Reporting Structure: 4 direct reports, 8 indirect reports; reported to the Nursing Director.
BRIGHAM AND WOMENS’ HOSPITAL- Southern Jamaica Plain Health Ctr. Jamaica Plain, MA
Case Manager 04/11- 09/12
 Identify those clients in need of case management; identify areas of medical and social concern.
 Interacting with families and individuals to assess their needs and find social programs to assist.
 Provide and identify case management need to high risk OB patients of the BWH Perinatal Case
Management program.
 Collaborate with clinical staff in the development and execution of the plan of care, and achievement
of goals.
 Establish and maintain professional relationships with local community resources (Healthy Baby
Healthy Child, Cradles to Crayons, Fragment Society, ETHOS, and neighboring health centers).
 Maintain database of patient case load.
 Provide patients with guidance, support, education and counseling to ensure coordination of care.

2. PARTNERS HEALTHCARE-Patient Service Center (PSC) Medford, MA
Managed Care Supervisor 02/08-04/11
 Provide supervisory oversight, support and guidance for a team of 24 Managed Care Representatives.
 Utilize strong interpersonal and communication skills to motivate and mentor staff with a focus on
increasing productivity.
 Provide senior management with various statistical, written and performance reports in a timely
manner.
 Provide staff with guidance and support in working with various insurance providers on matters related
to collection problems.
 Serve as liaison between senior management and Managed Care Representatives to
communicate new organizational policies or requirements.
 Reporting Structure: 12 direct reports, 24 indirect reports; reported to the Operations Manager.
PARTNERS HEALTHCARE-Patient Service Center (PSC) Medford, MA
Managed Care Representative 08/07 – 02/08
 Provided on-site referral management support to patients of Brigham and Women’s Southern Jamaica
Plain Health Center; coordinated approvals/denials by providers and processed all requests.
 Communicated referral management requirements to all patients and obtained all external approvals.
 Utilized on-line tools to process referral and authorizations; accurately updated the registration/billing
system with approval criteria.
 Provided confidential customer care to patients in both English and Spanish at the Partners
Healthcare Patient Service Center assisting with all referral, claims and billing related issues;
contacted payers when necessary to get an explanation of benefits and/or have claims adjudicated.
 Coordinated referral requests, approvals and denials between primary care providers and patients.
 Followed-up on all denied requests and advised patients how to proceed.
GUSO’S ITALIAN GRILL Clermont, FL
Restaurant Manager 12/06-07/07
 Manage restaurant operations, including coordination and synchronization of multiple work teams to
provide efficient service while maintaining high organizational standards for quality
 Conceptualize and implement innovative business and marketing plans to increase sales and
organization's profitability.
 Review and analysis of sales, provide senior management with detailed financial and budget reports.
 Provide senior management with recommendations on streamlining operations and lowering operating
costs with a view to maximizing profitability.
 Implement new staff development and training plans focused on recruitment and retention of
motivated staff.
 Develop employee training and recognition program.
 Develop organizational service standards to provide guests with high quality experience.
 Act as primary point of contact for guests - from reception to addressing their concerns with their
experience during a visit.

3. HANGAR PROSTHETICS AND ORTHOTICS Ocoee, FL
Operations Manager 10/05-12/06
 Supervise the daily Referral and Pre-Registration process of 30 + employees within 9 clinics.
 Assist with employee productivity reviews.
 Attend weekly, monthly Team Forums for up to date hospital and insurance information.
 Manage the daily workload of a Managed Care Coordinator and assist her with same day, next day
surgical procedures as well as self-pay patients for surgical procedures.
EDUCATION
College for America/ Southern New Hampshire University
A.G.S. Associates Degree in General Studies / in progress
Suffolk University
Community Health & Community Health Center Management Certificate Program
Certificate /2013
Comprehensive Outreach Education Certificate Program(COEC)
Certificate/ 2012
The Management Fundamentals Certificate Program/Professional Development Series Partners Health
Care & Brigham and Women’s Hospital
Management Training/ 2008-present
Waitt House/Madison Park High School Collaborative
Diploma/ 1993
References Available Upon Request