Diego Beltran Ramirez
Winnipeg,MB
Summary
Results-driven medical professional with expertise in compliance auditing and patient care coordination. Known for strong analytical and collaborative skills, contributing to improved documentation accuracy and streamlined billing processes. Aiming to leverage experience in healthcare auditing to enhance operational efficiency.
Overview
6
6
years of professional experience
Work History
Medical Auditor
Sanitas
Girardot, Cundinamarca (Colombia)
08.2024 - 06.2025
- Reviewed medical records for compliance with regulations and standards.
- Collaborated with healthcare teams to ensure accurate documentation practices.
- Conducted audits on billing procedures to identify discrepancies.
- Analyzed data for trends in coding accuracy and documentation completeness.
- Prepared reports summarizing audit findings for management review.
- Maintained confidentiality of patient information during audits.
- Utilized electronic health record systems to access and evaluate patient data.
- Based payment or denials of medical claims upon well-established criteria for claims processing.
- Collaborated with department managers, staff members, and other stakeholders to develop audit strategies and corrective action plans.
- Analyzed medical documents for completeness, accuracy, and compliance with applicable standards.
- Prepared written summaries outlining audit results along with recommendations for improvement.
Medical Coordinator
Salud Total Eps
Girardot, Cundinamarca (Colombia)
05.2022 - 08.2024
- Assisted in maintaining medical records and ensuring data accuracy.
- Communicated with healthcare providers to streamline patient referrals.
- Performed administrative tasks such as scheduling meetings, preparing reports, coordinating events.
- Assessed patient complaints or symptoms to determine appropriate course of action.
- Coordinated with other healthcare professionals such as nurses and doctors to ensure quality care for patients.
- Prepared weekly schedules for physician assistants, nurses detailing duties, responsibilities.
- Acted as a liaison between insurance companies, hospitals and other health organizations concerning payment issues.
- Coordinated insurance claims and documentation for timely processing.
Physician
Junical Medical SAS
Girardot, Cundinamarca (Colombia)
09.2019 - 05.2022
- Diagnosed patient conditions through comprehensive medical evaluations and examinations.
- Developed treatment plans based on patient needs and medical histories.
- Collaborated with healthcare teams to coordinate patient care and services.
- Educated patients on health management and preventive care strategies.
- Updated patient records accurately using electronic health record systems.
- Reviewed X-rays, MRI scans, CT scans and other imaging studies to diagnose conditions or diseases.
- Referred patients to medical specialists or other practitioners for more specialized courses of treatment.
- Assessed patient conditions to determine immediate medical needs.
- Administered emergency treatments and medications according to protocols.
- Collaborated with nursing staff to coordinate patient care effectively.
- Supervised junior physicians and medical interns during emergency procedures.
Education
Postgraduate Diploma - Specialist in Health Service Assurance And Audit
Fundacion Universitaria Juan N Corpas
Bogota Colombia12-2021
M.D. - Medical Doctor
Fundacion Universitaria Juan N Corpas
Bogota Colombia06-2013
High School Diploma -
ITI Francisco José De Caldas
Bogotá (Colombia)11-2006
Skills
- Medical coding
- Compliance auditing
- Claims processing
- Data analysis
- EHR utilization
- Risk management
Languages
Spanish
Native/ Bilingual
English
Limited
Timeline
Medical Auditor
Sanitas
08.2024 - 06.2025
Medical Coordinator
Salud Total Eps
05.2022 - 08.2024
Physician
Junical Medical SAS
09.2019 - 05.2022
Postgraduate Diploma - Specialist in Health Service Assurance And Audit
Fundacion Universitaria Juan N Corpas
M.D. - Medical Doctor
Fundacion Universitaria Juan N Corpas
High School Diploma -
ITI Francisco José De Caldas
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