Angela Rivas
Vallejo,CA
Summary
Dedicated , experienced , result driven and versatile professional with excellent organizational skills and leadership/relationship capabilities, seeking new challenges where my experience can be utilized to improve customer satisfaction.
Overview
14
14
years of professional experience
Work History
Independent Life Insurance Agent
UE Financial
07.2021 - Current
- Licensed in CA, OH, AZ, and FL
- Developed financial plans for clients, ensuring proper coverage and security for their families.
- Generated new business leads through networking events, referrals, and community involvement.
- Educated clients on the importance of life insurance, leading to informed decision-making
- Developed a high-performing team through recruitment, comprehensive training, and ongoing mentorship.
Case Reimbursement Manager
Raptor Horizon Pharmaceuticals
11.2015 - 10.2021
- Managed entire reimbursement case load for companies products nationwide.
- Follow company policies for reimbursement support of written prescriptions, including, benefit investigation, prior authorizations, appeals, coordination of doctors, nurses, patients, pharmacy, regional business managers, and other internal case managers to ensure prescriptions are dispensed in a timely manner
- Managed a team of reimbursement specialists, providing guidance and support for optimal performance.
- Improved patient satisfaction by ensuring timely and accurate reimbursements for their medical expenses.
- Maintained up-to-date knowledge on national healthcare policies affecting reimbursements, advising senior leadership on necessary adjustments, open enrollment or updates to internal processes accordingly.
- Resolved day to day emergencies with refills/ shipments with specialty pharmacy leads
- Managed internal HUB case managers, point of contact for physicians, nurses, sales team, and patients
- Facilitated cross-functional meetings to discuss the impact of policy changes on the reimbursement process, ensuring clear understanding among all stakeholders.
- Effectively assisted in the transition of the company’s software systems and became a super-user.
- Enhanced client satisfaction by accurately communicating messages for spanish speaking patients.
Patient Account Representative II
Children’s Hospital
11.2014 - 11.2015
- Enhanced patient satisfaction by promptly addressing inquiries and resolving account issues.
- Streamlined billing processes for increased efficiency in managing patient accounts.
- Acted as departments customer service liaison.
- Maintained accurate records of all transactions, ensuring timely payments from patients and insurance providers.
- Identified trends in unpaid accounts, developing targeted solutions for improved revenue recovery.
- Collaborated with the medical staff to ensure proper documentation and coding for accurate billing.
Reimbursement Specialist
Presidio Surgery Center
04.2013 - 10.2014
- Established strong working relationships with insurance providers, fostering open communication channels for smoother claim resolutions.
- Assisted patients with understanding their benefits coverage, providing clear explanations regarding out-of-pocket expenses and reimbursements.
- Provided exceptional customer service when responding to patient inquiries about reimbursement status and procedures.
- Maintained comprehensive knowledge of healthcare billing practices, staying current on industry updates and changes in regulations.
- Improved departmental accuracy through meticulous attention to detail while reviewing claims submissions.
Collections Specialist
Children’s Hospital
09.2011 - 05.2013
- Streamlined the collections process by creating and maintaining detailed records of customer account statuses and communications.
- Maintained compliance with state and federal regulations during all collections activities, ensuring ethical business practices.
- Improved customer payment compliance through negotiating mutually agreeable repayment plans.
- Collaborated with cross-functional teams to identify potential at-risk accounts and develop preventative measures.
Implant Coordinator
Bayside Oral Surgery Group
07.2010 - 03.2011
- Managed project timelines for successful completion, ensuring milestones were met and deadlines were adhered to.
- Enhanced customer satisfaction by responding promptly to inquiries and addressing concerns professionally.
- Contributed to business growth by identifying opportunities for process improvement and recommending actionable solutions.
Education
Medical Administrative Assistant - Medical
Bryman College
San Francisco , CA01.2001
Skills
- Bilingual Spanish/ English
- HIPPA Expert
- Proficient with Microsoft Word and Microsoft Excel
- Creative Thinking
- Customer Support
- Data Entry and Filing
- Sales
- Email Marketing
- Building Relationships
- Problem-solving
- Organizational skills
- Strong communication
- Attention to detail
- Project Management
- Recruitment
- Networking
- Time management
- Self-motivation
- Empathy and understanding
- Analytical thinking
- Product knowledge
Timeline
Independent Life Insurance Agent
UE Financial
07.2021 - Current
Case Reimbursement Manager
Raptor Horizon Pharmaceuticals
11.2015 - 10.2021
Patient Account Representative II
Children’s Hospital
11.2014 - 11.2015
Reimbursement Specialist
Presidio Surgery Center
04.2013 - 10.2014
Collections Specialist
Children’s Hospital
09.2011 - 05.2013
Implant Coordinator
Bayside Oral Surgery Group
07.2010 - 03.2011
Medical Administrative Assistant - Medical
Bryman College
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