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Summary
Overview
Work History
Education
Skills
Software
Languages
Timeline
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Irene Vergara
Open To Work

Irene Vergara

Bellflower,CA

Work Preference

Job Search Status

Open to work
Desired start date: Immediately

Desired Job Title

Business Office ManagerHealth Center Medical Billing SpecialistBusiness Office ManagerRevenue Cycle ManagerBusiness Office Manager

Work Type

Full Time

Location Preference

On-SiteRemoteHybrid
Location: Bellflower, CA
Open to relocation: Yes

Salary Range

96000/yr - 200000/yr

Important To Me

Career advancementWork-life balanceCompany CultureFlexible work hoursPersonal development programsHealthcare benefitsWork from home option4-day work week

Summary

Results-driven and passionate professional with 10+ years of experience managing multiple revenue cycle management operations. Proven success determining improvement areas for documentation, workflow, and revenue cycle management process by utilizing effective problem-solving expertise. In-depth knowledge of federal, state, and all third-party insurance policies, practices, and procedures.

Overview

20
20
years of professional experience

Work History

Business Office Manager

Rose Villa Care Center
Bellflower, CA
07.2024 - Current
  • Managed monthly billing process to complete billings and receive reimbursements in a timely manner to meet company revenue recognition policies.
  • Boosted cash flow with effective billing strategies, closely monitoring aging reports and prioritizing high-value accounts for collection efforts.
  • Complied with established internal controls and policies.
  • Self-motivated, with a strong sense of personal responsibility.
  • Excellent communication skills, both verbal and written.

Business Office Manager

Life Care Center of Vista DBA Vista View Post Acute
Vista, CA
02.2022 - 07.2024
  • Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
  • Collaborated closely with clinical team to ensure proper documentation was obtained for accurate billing purposes.
  • Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
  • Continuously updated knowledge of industry regulations and compliance requirements, ensuring adherence to all applicable standards.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Maintained collections above 97% for all payers.
  • Assessed current revenue cycle procedures and implemented improvements to foster efficiency
  • Improved revenue cycle efficiency by streamlining processes and implementing best practices

Health Center Medical Billing Specialist

Casa de las Campanas
San Diego, CA
02.2018 - 09.2021
  • Manage overall Health Center billing operations, such as HMO and Medicare
  • Review treatment plans for changes in financial status by collaborating with Nursing Department Heads and Admissions
  • Supervise revised contracts with proper billing rates
  • Ensure fulfillment of benefits for all payers, including supplemental plans
  • Organize and oversee multiple functions of PPS meeting
  • Engage in monthly triple check process for Medicare part A, B, and Managed Care
  • Drive accuracy of billing and reimbursement by conducting accounts audit
  • Successfully mitigated outstanding aging for 120+ days
  • Administered end-to-end aspects of software by serving as PCC (Point Click Care) Security User
  • Gathered outstanding receivables by 97%
  • Oversaw overall aspects of accounts receivables from posting, collection calls/letters, appealing denials/underpayments, and updating notes in PCC.

Business Office Manager

Encinitas Nursing & Rehab
Encinitas, CA
01.2015 - 01.2017
  • Led various business activities, covering staff attendance, performance evaluations, and training of accounts receivable clerk, accounts payable, payroll, and receptionist
  • Enabled all insurance information for admissions
  • Recorded and secured collection efforts in Point Click Care
  • Checked daily census with manual census
  • Directed billing functions related to Medicare co-insurance to secondary payer, follow-up, resubmitting claims, and appeals for all managed care claims
  • Modernized contract books for Admissions, Case Manager, and Business Office
  • Verified accuracy of all demographics and payer trees; entered in PCC
  • Achieved promotion from Assistant Business Office Manager to Business Office Manager by exceeding performance expectations
  • Upgraded user access and verified PASRR's timely completion for all admissions by acting as administrator
  • Minimized DSO from 100+ to 38 within first six months
  • Decreased AR by processing process refunds and write-offs
  • Reviewed level of care for skilled patients through organization of weekly meeting with facility Case Manager.

Revenue Cycle Manager

LifeHouse Vista Healthcare Center
Vista, CA
01.2011 - 01.2015
  • Oversaw multiple activities, covering organization and prioritization of overall operations; managed competently and according to company's changing priorities and deadlines
  • Joined various meetings, like daily manager, PPS, and weekly UR meetings
  • Administered weekly/monthly billing for Medicare A and B, Medi-cal, Managed Care, Hospice, and Cal MediConnect plans as well as directed HealthNet, Care 1st, Molina, Community Health Group
  • Supported Executive Director in reviewing income statement and monthly variance reports
  • Drove billing accuracy by coordinating with several departments, such as MDS Nurse, Admissions Department, Rehab Department, Central Supply Department, Case Manager, and other departments
  • Steered resident trust account deposits, posting, replenishing petty cash, and month end reconciliation
  • Managed Medi-cal benefits twice a month to supervise share of cost increase/decrease, health plan changes, and loss/approval of benefits
  • Gathered monthly share of cost payments and outstanding private balances
  • Processed payroll under federal, state, and community guidelines
  • Earned promotion from Assistant Business Office Manager to Revenue Cycle Manager by surpassing performance expectations
  • Verified fulfillment of all policies and procedures applicable to business office operations and enabled compliance with department and organizational procedures
  • Allocated benefit plan materials to staff members and described employee options, plan summaries, and assisted in enrollment process.
  • Surpassed monthly collection goal from 107% to 115%
  • Developed and maintained accurate records for daily census at 305 bed facility
  • Streamlined end-to-end information through minimization of triple check meeting.

Business Office Manager

Life Care Center of Vista
Vista, CA
06.2006 - 07.2011
  • Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving.
  • Contributed to a successful annual audit by preparing thorough documentation in accordance with regulatory requirements.
  • Organized meetings for executives and coordinated availability of conference rooms for participants.
  • Developed and maintained strong relationships with vendors, negotiating contracts for cost savings and improved service quality.

Education

Bachelor of Science - Behavioral Health

Grand Canyon University
Phoenix, AZ
02.2026 - Current

Vocational - Medical Assistant

Concorde Career College
Garden Grove, CA
06.2003

Vocational - Medical Administrative Assistant

Kaplan University
Vista, CA
06.2000

Skills

  • Operations Management
  • Team Leadership & Direction
  • Billing & Insurance Claims
  • Reporting & Documentation
  • Issues Resolution
  • Strategic Planning & Execution
  • Compliance Management
  • Accounts Management
  • Healthcare Industry Knowledge
  • Claims Management
  • Cash Flow Management
  • Medical Billing
  • Denial Resolution
  • Problem-solving aptitude
  • Financial analysis and reporting
  • Proactive and Focused

Software

Point Click Care

DDE

Citrix Workplace

RevSprings

RFMS

SNF Tools

ProClaims

Waystar

Ultimus WebClient

Languages

Spanish
Native or Bilingual

Timeline

Bachelor of Science - Behavioral Health

Grand Canyon University
02.2026 - Current

Business Office Manager

Rose Villa Care Center
07.2024 - Current

Business Office Manager

Life Care Center of Vista DBA Vista View Post Acute
02.2022 - 07.2024

Health Center Medical Billing Specialist

Casa de las Campanas
02.2018 - 09.2021

Business Office Manager

Encinitas Nursing & Rehab
01.2015 - 01.2017

Revenue Cycle Manager

LifeHouse Vista Healthcare Center
01.2011 - 01.2015

Business Office Manager

Life Care Center of Vista
06.2006 - 07.2011

Vocational - Medical Assistant

Concorde Career College

Vocational - Medical Administrative Assistant

Kaplan University

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Irene Vergara