Amanda R. Lopez
San Francisco,CA
Summary
Healthcare professional with extensive experience in managing reimbursement tasks and resolving billing discrepancies. Proven ability to streamline processes and improve efficiency while maintaining compliance with industry standards. Valued team player who consistently achieves results through effective collaboration and adaptability.
Overview
21
21
years of professional experience
Work History
Senior (Level 3) Reimbursement Specialist
California Skin Institute (Acquired by Schweiger Dermatology)
01.2020 - Current
- Resolved payer-related challenges by creating and executing action plans to boost collections.
- Organized weekly sessions with top management to set and prioritize collection objectives.
- Contributed to the creation of procedures for billing in the Reimbursement Department.
- Identified trends in reimbursement denials, recommending process improvements to minimize future occurrences.
- Organized weekly discussions to analyze payer aging and preprocessing modifications involving direct and remote teams.
- Conducted regular audits of billing records, identifying areas where inconsistencies could be addressed to optimize efficiency within the department.
- Collaborated with collections team to identify patterns in denials.
Financial Coordinator
Orthodontist Pediatric Dentistry San Francisco
01.2019 - 01.2020
- Supported the financial strategy by meeting financial goals established for the practice.
- Uploaded electronic funds transfers from Delta Dental, MetLife, Aetna and Cigna and post to Dentrix System.
- Reviewed and close out End of Day Production - Day Sheet, Adjustments and Deposit Slip.
- Evaluated accounts receivables in Pediatric and implement a system to hold AR at a healthy level monthly.
- Monitored all insurance claims processing, billing statements and payment arrangements followed OPDSF financial policy.
- Trained finance staff on new protocol and policies developed for the betterment of OPDSF.
- Provided staff support wherever needed.
Billing Manager, Follow-Up
Myriad Women’s Health (Formerly Counsyl, Inc.)
01.2017 - 01.2019
- Mentored an Associate Manager while leading 8 Reimbursement Associate team members in order to meet company goals.
- Worked closely with team on insurance billing including claims, follow up, website inquiries, adjustments and conversion to patient billing.
- Audited staff work and review aging monthly.
- Supported and empowered team to maintain the billing system, including contract pricing, test coding, remittance information and advanced knowledge of billing system functions and processes.
- Coordinated insurance billing issues and resolution with Managed Markets, Customer Service and Insurance Maintenance.
- Managed insurance Days of Sales Outstanding and old accounts to meet company goals.
Reimbursement and Billing Manager
CareDx, Inc. (Formerly XDx, Inc.)
01.2014 - 01.2017
- Responsible for managing reimbursement staff of 14 with revenue of 22M.
- Facilitated strategic planning process and continuous quality improvement projects.
- Participated and directed efforts to comply with SOX and financial audit requests.
- Updated current reimbursement policies with new billing system.
- Identify any payer issues or trends impacting preprocessing of claims and improve collections efforts by implementing an action plan to resolve.
- Worked with individual staff to improve collections efforts and maximize productivity.
- Managed client (Roster) invoices and collections to ensure payments received before next billing cycle.
- Weekly meetings with upper management team in prioritizing target collections goals.
- Helped with billing policy and procedures for Reimbursement Department.
- Interacted with Sales Team to support customer base regarding reimbursement issues.
- Assisted Finance group in efforts to comply with SOX audit requests.
- Conducted weekly team meetings to review payer aging, preprocessing changes, with direct and remote teams.
- Coordinated with Director of Finance to ensure month end reports and research meet close deadlines.
- Collaborated with collections team on denial trends and train them on how to take action.
- Partnered with Management on transition of legacy billing system to new RCM system.
- Led team to meet or exceed quarter goals in 2016 and 2017.
- Hired and trained 8 new reimbursement specialists within 2 months.
Accounts Receivable Supervisor
Quest Diagnostics, Alameda CA (Formerly Berkeley Heart Lab)
Alameda, CA
01.2011 - 01.2013
- Responsible for overseeing Accounts Receivable department with a staff of 22.
- Trained all members of the Billing and Revenue Services Department, consistently achieving high productivity.
- Evaluated and identified team member strengths, determined appropriate placement within the department.
- Collaborated with leadership on determining various collection issues and providing the guidance to AR Team with the appropriate collection process, which helped reduce aging.
- Managed several collection projects, resulting in monthly goals met every month.
- Oversaw claims to Third Party and government payers electronically and manually, ensuring policies met payer guidelines.
- Developed and coached team members on resolving patient insurance copay balances, by verifying proper payment and charges from the payer.
- Monitored and directed collection efforts including assigning follow up of denials and overseeing appeals process.
- Coached 5 leads on delegating, tasks, ensuring collection goals were met within established timelines.
- Created adjustment forms, enabling other departments and management to identify accurate reimbursements.
- Developed a well-rounded staff, which enabled them to provide assistance in other departments.
Multiple promotions: Accounts Receivable Supervisor, Lead and Senior A/R Specialist
Monogram Biosciences, Inc. – South San Francisco, CA
South San Francisco, CA
01.2005 - 01.2011
- Completed quarterly appraisals for direct reports.
- Participated in month-end duties to include (but not limited to) bad debt reporting and review of third party client invoice drafts.
- Reconciled payer accounts for month end close.
- Monitored and oversaw billing processes to ensure that all transactions are billed properly.
- Assisted with questions or issues from E & A Collection Agency.
Education
General Studies
City College of San Francisco
San Francisco, CABusiness Studies
Heald Business School SF
Skills
- Nextech
- Trizetto
- TELCOR
- Zirmed
- Office Ally
- Appeals handling
- Claims processing
- Microsoft office
- Insurance verification
- Denial management
- Medical billing
- Medicaid
- Eligibility verification
- Medicare
- Commercial insurance
Timeline
Senior (Level 3) Reimbursement Specialist
California Skin Institute (Acquired by Schweiger Dermatology)
01.2020 - Current
Financial Coordinator
Orthodontist Pediatric Dentistry San Francisco
01.2019 - 01.2020
Billing Manager, Follow-Up
Myriad Women’s Health (Formerly Counsyl, Inc.)
01.2017 - 01.2019
Reimbursement and Billing Manager
CareDx, Inc. (Formerly XDx, Inc.)
01.2014 - 01.2017
Accounts Receivable Supervisor
Quest Diagnostics, Alameda CA (Formerly Berkeley Heart Lab)
01.2011 - 01.2013
Multiple promotions: Accounts Receivable Supervisor, Lead and Senior A/R Specialist
Monogram Biosciences, Inc. – South San Francisco, CA
01.2005 - 01.2011
Business Studies
Heald Business School SF
General Studies
City College of San Francisco