Adriana Rivera
Modesto,CA
Summary
Healthcare revenue cycle professional with 5+ years in billing and claims operations, specializing in insurance payment posting and EOB review. Ensures HIPAA-compliant documentation and accurate claim resolution. Provides bilingual English-Spanish client support and resolves posting discrepancies through root-cause analysis.
Overview
7
7
years of professional experience
Work History
Case Manager/Class Facilitator
Sierra Vista
Modesto, California
01.2026 - 06.2026
- Referred clients to housing, counseling, benefits, and community support programs.
- Guided clients through intake, eligibility, and service enrollment steps.
- Provided case management services including intake, assessment, crisis intervention, advocacy, referral and monitoring of families.
- Monitored client progress through regular follow-up contacts.
Patient Account Representative
American Advanced Management
Salida , Ca
09.2025 - 12.2025
- Managed patient billing inquiries using hospital account systems.
- Reviewed insurance claims and corrected account discrepancies.
- Posted payments and adjusted balances in billing records.
- Resolved denied claims through follow-up and documentation review.
- Reviewed EOBs statements submitted by insurance companies for accuracy against provider's charges.
- Performed basic administrative duties by answering calls, taking messages, data entry, typing tasks and locating files upon request.
Accounts Receivable and Billing Specialist
Vituity
Modesto, CA
05.2019 - 08.2025
- Processed healthcare claims and invoices for physician billing operations.
- Resolved denied claims with insurers and internal billing departments.
- Updated account notes and documentation for accurate medical billing follow-up.
- Reviewed accounts receivable aging reports for Vituity revenue cycle teams.
- Applied payments and adjustments in billing and practice management systems.
- Supervised daily operations and guided staff across company workflows.
- Trained new employees on company policies, job duties, and performance expectations.
- Reviewed reports, logs, and records for company supervisors and managers.
- Monitored employee productivity to provide constructive feedback and coaching.
Education
High School Diploma -
Billy Joe Dickens High School
Hughson 05-2012
Skills
- Case management
- Client assessment
- Eligibility screening
- Insurance claims
- Critical thinking
- Active listening
- Time management
- Microsoft Excel
- Problem-solving
- EMR / EHR
- HIPAA compliance
- Claims processing
- Payment posting
- EOB review
- Bilingual: English and Spanish (Fluent)
Timeline
Case Manager/Class Facilitator
Sierra Vista
01.2026 - 06.2026
Patient Account Representative
American Advanced Management
09.2025 - 12.2025
Accounts Receivable and Billing Specialist
Vituity
05.2019 - 08.2025
High School Diploma -
Billy Joe Dickens High School