Blanca Ramirez

Results-driven Healthcare Administration and Operations professional with 10+ years of progressive experience leading teams, managing office operations, improving customer service, and supporting healthcare and government programs. Proven ability to supervise employees, streamline workflows, resolve complex client issues, and ensure compliance with Medicare, Medicaid, HIPAA, and organizational policies. Recognized for building high-performing teams, improving operational efficiency, and delivering exceptional customer experiences.

Bilingual in English and Spanish.

Customer Service Specialist - Department of Human Services – Food Stamps/Medicaid/LTC/TANF - Colorado Springs, CO

(2024-08)

• Assisted clients with questions regarding SNAP food benefits, Medicaid, Long-Term Care, and Temporary Assistance for Needy Families programs.
• Reviewed client information, explained eligibility requirements, and provided guidance on applications, renewals, required documentation, and case status.
• Managed a high volume of client inquiries through telephone, in-person, and electronic communication while maintaining accuracy and professionalism.
• Researched complex cases, identified discrepancies, and coordinated with eligibility workers and internal departments to support timely resolution.
• Documented client interactions and case updates accurately in state systems while protecting confidential personal and financial information.
• Explained agency policies, program requirements, deadlines, and appeal procedures in clear, understandable language.
• De-escalated challenging situations and resolved complaints with empathy, sound judgment, and a client-focused approach.
• Maintained compliance with federal and state regulations, confidentiality requirements, and departmental procedures.
• Prioritized multiple cases and time-sensitive requests while consistently meeting productivity, quality, and service standards.
• Served as a knowledgeable resource for clients navigating public assistance programs and community support services.

Medicare Customer Service Representative - Maximus - El Paso, TX

(2023-11 - 2024-07)

• Assisted Medicare beneficiaries by providing accurate information regarding eligibility, enrollment, benefits, claims, billing, and prescription drug coverage.
• Resolved complex customer inquiries while ensuring compliance with CMS regulations, HIPAA, and company policies.
• Handled a high volume of inbound calls, consistently meeting productivity, quality assurance, and customer satisfaction performance metrics.
• Researched and resolved escalated issues by coordinating with internal departments and healthcare providers to ensure timely resolutions.
• Educated beneficiaries on Medicare plans, coverage options, and available resources to support informed healthcare decisions.
• Accurately documented customer interactions and case resolutions in multiple systems while maintaining confidentiality and data integrity.
• Demonstrated strong problem-solving, active listening, and conflict resolution skills to deliver exceptional customer service in a fast-paced environment.
• Recognized for maintaining high-quality standards, professionalism, and efficiency while meeting key performance indicators (KPIs). Ensured compliance with Medicare regulations.

Mental Health Technician - El Paso Behavioral Health System - El Paso, TX

(2022-07 - 2024-07)

• Provided direct care and emotional support to patients experiencing behavioral health and psychiatric challenges in a structured clinical environment.
• Monitored patient behavior, safety, and overall well-being and promptly reported significant changes to nurses and clinical staff.
• Assisted patients with daily living activities while promoting independence, dignity, and treatment-plan compliance.
• Conducted safety checks and maintained a secure, therapeutic environment in accordance with facility policies and regulatory standards.
• Used de-escalation and crisis-intervention techniques to manage challenging behaviors and reduce safety risks.
• Documented patient observations, incidents, and care activities accurately in electronic medical records.
• Collaborated with nurses, physicians, therapists, and other healthcare professionals to support individualized treatment goals.
• Maintained patient confidentiality and complied with HIPAA, infection-control, and behavioral health procedures.

Social Media Ads Moderator (TikTok) - Teleperformance USA - Remote

(2020-07 - 2022-07)

• Reviewed and moderated high volumes of user-generated advertising content to ensure compliance with TikTok community guidelines, advertising policies, and legal requirements.
• Applied critical thinking and sound judgment to evaluate sensitive, complex, and time-sensitive content while maintaining accuracy and productivity standards.
• Identified policy violations, escalated high-risk content, and documented findings according to established procedures.
• Maintained strict confidentiality and safeguarded sensitive user information in compliance with company policies and data privacy standards.
• Adapted quickly to evolving platform policies, workflow updates, and quality expectations in a fast-paced, metric-driven environment.
• Collaborated with cross-functional teams to improve content quality, consistency, and operational efficiency while meeting daily performance goals.
• Consistently achieved quality and productivity targets in a high-volume environment requiring attention to detail and sound decision-making.

Patient Account Representative - El Paso Orthopedic Surgery Group - El Paso, TX

(2015-05 - 2018-03)

• Managed patient accounts by verifying insurance eligibility, processing authorizations, and resolving billing and claims issues.
• Assisted patients with billing inquiries, payment arrangements, and account balances while delivering exceptional customer service.
• Processed insurance claims, followed up on unpaid claims, and coordinated with insurance carriers to ensure timely reimbursement.
• Maintained accurate patient records and documented account activity in compliance with HIPAA and organizational policies.
• Collaborated with physicians, clinical staff, and insurance providers to resolve account discrepancies and support continuity of patient care.
• Collected patient payments, posted transactions, and reconciled accounts to ensure financial accuracy.
• Reviewed medical documentation and insurance information to support accurate billing and claims processing.
• Managed multiple priorities in a fast-paced healthcare environment while maintaining accuracy, professionalism, and high-quality service.

Office Manager/Tax Preparer - Liberty Tax Service - Las Vegas, NV & El Paso, TX

(2014-01 - 2016-04)

• Directed daily office operations while preparing individual and small business federal and state tax returns, ensuring accuracy, efficiency, and compliance with federal, state, and company regulations.
• Recruited, hired, trained, coached, and supervised office staff, fostering a collaborative, high-performing team and delivering exceptional customer service.
• Managed payroll, scheduling, bookkeeping, accounts receivable, budgeting, and financial reporting to support operational and financial goals.
• Interviewed clients, reviewed financial documents, identified eligible deductions and tax credits, and advised on tax laws and filing requirements.
• Utilized professional tax software to prepare, review, and electronically file tax returns while maintaining confidential client records.
• Assisted clients with IRS correspondence, audit support, and resolution of tax-related issues.
• Developed office procedures that improved workflow efficiency, monitored performance metrics, and helped achieve revenue and productivity goals.
• Planned marketing and community outreach initiatives, resolved escalated customer concerns, and built long-term client relationships through outstanding service.

Team Leader – (BCBS of California) Customer Service Call Center - HGS - El Paso, TX

(2013-06 - 2015-05)

• Led and coached a team of customer service representatives, ensuring consistent achievement of quality, productivity, and customer satisfaction goals.
• Monitored daily performance metrics, including call quality, adherence, and productivity, and provided coaching to improve individual and team performance.
• Conducted new hire training, ongoing development to build a knowledgeable and high-performing team.
• Resolved escalated member inquiries involving health insurance benefits, claims, billing, and eligibility while maintaining compliance with HIPAA and company policies.
• Performed regular performance evaluations, delivered constructive feedback, and implemented performance improvement plans when needed.
• Collaborated with management to identify workflow improvements, increase operational efficiency, and enhance customer experience.
• Scheduled staff monitored attendance and ensured adequate coverage to meet service level agreements in a high-volume call center.
• Recognized for fostering a positive team environment through effective communication, employee engagement, and accountability.

Donor Processor - Biomat USA (Grifols Plasma) - Las Vegas, NV

(2012-10 - 2013-09)

Performed donor registration, eligibility verification, and medical history screening while ensuring compliance with FDA regulations.