Angelita Ruiz

Quality Advocate at Asynchrony Labs
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Contact Information
us****@****om
(386) 825-5501
Location
Hazelwood, Missouri, United States, US
Skills

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Bio

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Credentials

  • PreHospital Care (EMT) training
    IL + MO
    Dec, 2010
    - Oct, 2024

Experience

  • Asynchrony Labs
    • United States
    • Software Development
    • 1 - 100 Employee
    • Quality Advocate
      • Nov 2015 - Present

      Work in team setting to help create applications per Client needs. Strategic Consulting in all stages of application development (inception to release). Work in team setting to help create applications per Client needs. Strategic Consulting in all stages of application development (inception to release).

  • Express Scripts Inc
    • United States
    • Senior Eligibility Analyst
      • Apr 2014 - Oct 2014

      Cross-functional duties, with exposure and knowledge of IT, CBA, billing, file transfer, Eligibility and client/vendor relations. Support Account Management, Business Analysts, IT and CBA with Operational research and analysis. Eligibility research, viewing of inbound and outbound data files, Point of Sale processing data, response codes, analyze data for trends/discrepancy and/or issues, update accumulator values, suggest/create work plans to resolve issues, and other duties as assigned. Transition period has been extended (Merger of ESI and Medco accounts), duties are mainly in faster-paced IMT (Issue Management Team) setting. Critical items require resolution in 72 hours. Show less

  • Express Scripts
    • United States
    • Hospitals and Health Care
    • 700 & Above Employee
    • Claims Specialist
      • Jul 2006 - Apr 2014

      Specialists function to adjudicate medical pharmacy insurance claims at the second tier level for Department of Defense (DoD) and government employees and their families. Processing claims requires an Automatic Data Processing II Government Security Clearance, adherence to current strict HIPAA (national standards for electronic health care transactions and national identifiers) and updated regulations in oral and written applications and superior data entry proficiency. Specialists utilize current DoD guidelines to verify and validate eligibility of member, agency and pharmacy submitted claim forms and identify claims requiring special exemption handling which requires knowledge of drugs, drug terminology and clinical diagnostic coding. Oral and written communication with ESI internal departments, members, pharmacies or state agencies are required to resolve open claim issues. Specialists provide accurate and timely claims processing, prioritize and coordinate the influx of daily claims workload for processing including re-processed claims and out-going correspondence. Assess accuracy of system adjudication process and alert management of potential problems. Analyze claims for potential fraud by member or pharmacy. Currently one of only three of the originally 80-plus, current 32, Claims processors trained across disciplines of Workers Comp and Medicaid/Medicare. Chair : Emergency Preparedness Committee, Author of the Policy + Procedures Manual for Disaster Management used internally for Saint Louis Offices. Engineer: Turnaround Time (TAT) calendar utilized for entire department. Inter-Departmental Senate Committee Member with responsibilities to improve work environment and production Sunshine Group Coordinator- organize, collect funds, delegate responsibilities for celebrations of team-mate special days. Recipient of Multiple awards for accuracy, production, attendance and exceptional assistance. Show less

  • ProStaff
    • Environmental Services
    • 1 - 100 Employee
    • Temp
      • Jan 2006 - Jul 2006

      Work as temp at Express Scripts. Data entry, HIPPA compliance, verification, and accounting. Position requires a security clearance to view sensitive material in DEERS. Work as temp at Express Scripts. Data entry, HIPPA compliance, verification, and accounting. Position requires a security clearance to view sensitive material in DEERS.

  • Home Depot
    • Construction
    • 700 & Above Employee
    • Cashier
      • Apr 2004 - Dec 2005

      Customer service, accounting, internal communication and conflict resolution. Primarily worked Returns; consisted of attention to detail, organization, knowledge of all departments, ability to adapt to new technology, phone skills, and generally making people Customer service, accounting, internal communication and conflict resolution. Primarily worked Returns; consisted of attention to detail, organization, knowledge of all departments, ability to adapt to new technology, phone skills, and generally making people

  • San Francisco Music Box
    • Wholesale
    • 1 - 100 Employee
    • Sales Associate
      • Aug 2003 - Dec 2003

      Secondary Assistant Manager. Duties included: money handling, nightly deposits, pricing, register, mounting moments into music boxes, customer service and light cleaning. Was seasonal help until notification of closure. Secondary Assistant Manager. Duties included: money handling, nightly deposits, pricing, register, mounting moments into music boxes, customer service and light cleaning. Was seasonal help until notification of closure.

  • Starbuck's
    • Education Management
    • 1 - 100 Employee
    • Barista
      • Jan 2003 - May 2003

      Took orders, customer service, manage register, assembled drinks using an automated espresso machine or restaurant quality blender. Other duties: inventory, minor mechanical evaluation and janitorial. This was an on-campus position while still in school. Took orders, customer service, manage register, assembled drinks using an automated espresso machine or restaurant quality blender. Other duties: inventory, minor mechanical evaluation and janitorial. This was an on-campus position while still in school.

  • Ruiz Medical Services
    • Secretary
      • Jan 1990 - Aug 1990

      Clerical, money handling, copying, filing, sanitation, babysitting children, interpersonal communication and inventory. Clerical, money handling, copying, filing, sanitation, babysitting children, interpersonal communication and inventory.

Education

  • SWIC
    certificate, PreHospital Care (EMT)
    2010 - 2010
  • University of Missouri-Saint Louis
    continued education, Business and Law
    2009 - 2009
  • Southern Illinois University Edwardsville
    Bachelor's, Mechanical Engineering
    1999 - 2003

Community

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