Ruth Carrera Email and Phone Number
I’m the Health Services Department Lead for El Paso Health, with 15+ years of experience within the same manage care organization. I have worked in several departments, expanding my knowledge within each position. Positions such as, Enrollment Specialist, Utilization Review Tech, and Complaints and Appeals Specialist. Having worked within the same company in several departments has provided me with the opportunity of department lead. I contribute to developing process flows, training material and train new associates. In this role I have contributed to new process implementations, testing and auditing. I enjoy what I do! My fast learning and attention to detail has led me to become a super-utilizer for the department. I’m very versatile and energetic individual. I’m very resourceful worker and great at managing different complex issues, concerns, or questions. As the lead I’m to ensure everyone’s questions are answered and are following the right process. I enjoy being able to make other’s job stress free. I’m a graduate of Irvin High School in El Paso, Tx, and a graduate from Western Technical College. I’m currently pursing my bachelor’s in business management in healthcare. I’m always interested in hearing from former colleagues, managers, and creative individuals. Please feel free to contact me if you’d like to connect.
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Health Services Program LeadEl Paso Health Aug 2019 - PresentEl Paso, Texas, United StatesAssist supervisor on daily process flows for departmentMaintain statistical data pertaining to the department work volume and trends on a monthly basisCoordinate and organize committee meeting to include: sending out invitation, reserve facility, order food and refreshments, prepare agenda, Utilization Management data and minutes.Run and distribute Board of Directors report.Designated person to test system and application upgrades.Maintain training material and responsible for training new staffOrder department supplies and maintain inventoryDevelop and maintain Standard Operating Procedures (SOP)Serve as super utilizer person for the department
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Complaints And Appeal SpecialistEl Paso Health Feb 2017 - Aug 2019El Paso, Texas, United States Handle, sort and acknowledge all incoming appeals and complaints. Resolved appeals and complaints to include review, research, and work in collaboration with various departments such as, Claims, Health Services, Contracting and Provider Relations. Composed provider appeal resolution letters and member complaints resolution letters Knowledge in provider contracts reimbursement. Knowledge in Texas Medicaid Provider Procedure Manual (TMPPM) and Center for Medicaid and Medicare Services (CMS)
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Health Service Program CoordinatorEl Paso Health Jun 2012 - Feb 2017El Paso, Texas, United States Assist the Health Services (HS) Administrative Supervisor in monitoring daily process flows for the HS Intake Unit. Develop and maintain Standard Operating Procedures (SOP’s) Prepare correspondence related to appeals from providers and members. Develop and maintain training material and process flows for new staff Maintain statistical data pertaining to the department work volume and trends on a monthly basis for Board of Directors to include CEO, Medical Director, Department Director, and Supervisors. Extensive knowledge related on the denial and appeal process. Coordinate and organize the Utilization Management (UM) and prepare data such as, statistical data. Designated tester for QNXT upgrades and other application upgrades (i.e. ICD-10) which requires I.T. training. Order supplies and maintain inventory of departmental supplies Serve as a super utilizer person for the department “the go-to person”
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Utilization Review TechnicianEl Paso Health Jul 2008 - Jun 2012El Paso, Texas, United States Take incoming provider calls for Care Management Indigent Program Screen incoming provider and facility Inpatient and Outpatient Pre-cert forms for authorization Assist with provider claims reconciliation Assist with preparation of reports, documents and /or other materials Mail Member and Provider approval notifications
Ruth Carrera Education Details
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Health Information/Medical Records Technology/Technician -
High School Diploma
Frequently Asked Questions about Ruth Carrera
What company does Ruth Carrera work for?
Ruth Carrera works for El Paso Health
What is Ruth Carrera's role at the current company?
Ruth Carrera's current role is Department lead at El Paso Health a non-profit manage care organization.
What schools did Ruth Carrera attend?
Ruth Carrera attended Park University, Western Technical College, Irvin High School.
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Ruth Carrera
United States -
Ruth Carrera
Los Angeles, Ca -
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Ruth Carrera
Certified Surgical Technologist At Ut Southwestern Medical CenterDallas-Fort Worth Metroplex1utsouthwestern.edu
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