Ramon Viscarra

Administration | Asset Management Consulting at Triad Unlimited
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Contact Information
us****@****om
(386) 825-5501
Location
San Francisco Bay Area, US
Skills

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Credentials

  • ORACLE NETSUITE ESSENTIALS
    Oracle
    Apr, 2019
    - Oct, 2024
  • Prosci Certified Change Practitioner
    Prosci
    Mar, 2019
    - Oct, 2024
  • IEA Claims Professional Certificate
    Insurance Education Asssociation
    Sep, 2000
    - Oct, 2024

Experience

  • Triad Unlimited
    • United States
    • Consumer Goods
    • Administration | Asset Management Consulting
      • Jan 2020 - Present

      NetSuite System Administrator dedicated to company support, overall system maintenance, applications, and project management support. Work closely with our development team, managing system configuration, implementation and overall system administration.➢ Provide day-to-day user and profile support of all Netsuite users➢ Maintain user accounts, passwords, and permissions➢ Prepare and maintain end-user documentation➢ Provide basic instruction to Netsuite users➢ Generate standard Netsuite reports and time permitting generate customized reporting➢ As time permits, assist with Netsuite application configurations➢ Assist users with analytics and report design and management.

    • Operations | Field Engineering Specialist
      • Jan 2018 - Present

      An Operations and Field Engineering Specialist well versed in project management support and execution of detailed project plans and schedule adherence. Experience collaborating with customers and project team members to ensure alignment to project deliverable. Excellent tracking and organizational skills. Ability to work under minimal supervision and resourceful in finding solutions to complex issues. Respected as a dynamic team builder, hands-on leader, and creative solutions provider. Self-motivated with high energy levels, great networking skills, capable of taking ownership and adapting to the demands of a rapidly growing organization.Possess strong skillset inclusive of:➢ Project Management➢ Planning & Scheduling➢ Change Management➢ Data Standardization➢ Asset Walk downs➢ Data Gathering and Analysis➢ Job Plan Creation➢ Database Administration➢ Technical drawing comprehension➢ P&ID creation and review➢ Technical Writing Development ➢ Quality Assurance ➢ Recruiting & Talent Acquisition

  • Social Security Administration
    • Government Administration
    • 700 & Above Employee
    • Claims Authorizer
      • 2014 - 2017

      Responsible for the execution of a large caseload quality review and servicing implementation oversight to the American Public in the adjudication and authorization of Internet processed retirement claims, and Medicare Enrollment. Proficient in counseling qualified individuals as it related to the rules and regulations of retirement programs. High level Customer Service Specialist, with a strong attention to detail. Responsible for the execution of a large caseload quality review and servicing implementation oversight to the American Public in the adjudication and authorization of Internet processed retirement claims, and Medicare Enrollment. Proficient in counseling qualified individuals as it related to the rules and regulations of retirement programs. High level Customer Service Specialist, with a strong attention to detail.

  • Sedgwick CMS
    • United States
    • Medical Practices
    • 1 - 100 Employee
    • Medical Claims Examiner
      • 2007 - 2013

      Claims Examiner I • Quality oversight of claims accuracy and viability• Adjust medical-only and minor lost-time workers compensation claims • Handled high volume medical-only case load of 300-500 open claims at a time• Process workers compensation claims determining compensability and benefits due• Process assigned claims and determines benefits due pursuant to the client contract; makes timely claims payments and adjustments• Communicate claim action/processing with claimant, client and appropriate medical contact within 24 hours• Ensure claims files are properly documented and claims coding is correct• Ensure medical bill coding was conducted and sent to bill review for processing• Complete payment processing manually for bills that were non-reviewable items• Process and indexed daily mail using paperless SIR system, five days current• Conducted claimant interviews using interpreting services• Maintain professional client relationships• Received IEA certificate • Proficient in IVOS SystemClaims Assistant • Administered Medical Only claims, ensuring timely processing of claims and payment of benefits• Managed and directed medical treatment, and setting reserves• Provided clerical and technical assistance to Senior Claims Examiner• Issued all indemnity payments and awards on time• Set up and entered new claims into claims management system• Input and review notes/diaries in claims management system

  • TIG Insurance Company
    • United States
    • IT Services and IT Consulting
    • Claims Service Specialist
      • 2005 - 2007

      • Quality oversight of claims accuracy and viability • Administered Medical Only caseload, ensuring timely processing of claims and payment of benefits• Provided technical assistance to Senior Claims Examiner• Set up and arranged travel for Med-Legal appointment and depositions • Quality oversight of claims accuracy and viability • Administered Medical Only caseload, ensuring timely processing of claims and payment of benefits• Provided technical assistance to Senior Claims Examiner• Set up and arranged travel for Med-Legal appointment and depositions

  • Athens Administrators
    • United States
    • Insurance
    • 200 - 300 Employee
    • Medical Claims Examiner
      • 1998 - 2005

      • Provided technical assistance to Senior Claims Examiners • Administered Medical Only caseload, ensuring timely processing of claims and payment of benefits• Managed and directed medical treatment, and setting reserves• Processed new claims in compliance with client’s Service Agreement• Issued all indemnity payments and awards on time• Processed all approved provider bills timely• Prepared objection letters to providers for medical bills; delayed or denied• Answered questions over the phone from medical providers regarding bills• Contacted treating physician for disability status• Contacted employer for return to work status or availability of modified work• Contacted injured worker at initial set up• Sent Division of Workers Comp (DWC) notices timely• Calculated wage statements and adjust disability rates as required• Kept diary for all delay dates and indemnity payments• Scheduled appointments for AME, QME evaluations• Requested Employer’s Report, DWC-1, Doctor’s First Report if needed• File and serve documents on attorneys, WCAB, doctors• Served PTP’s with medical file and Duties of Treating Physician (9785)• Drafted Stipulated Awards and C&R’ s• Submitted C&R, Stipulated Awards to WCAB for approval with documentation• Processed checks – stop payment, cancellations, void, journal payments• Completed penalty calculations and prepare penalty worksheets•Completed MPN,HCO and/or EDI coding• Contacted clients, injured workers, attorneys, doctors, vendors and other parties• Provided updates of claims status to Senior Claims Examiners and Athens management

Education

  • Los Medanos College
    1989 - 1991
  • Villinova University
    Lean Six Sigma Green Belt Coursework
    2018 -
  • Society of Maintenance and Reliability Professionals
    Certified Maintenance & Reliability Professional, Certification Coursework
    -

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