Brenda Rivera
Blackstone,MA
Summary
Seasoned professional with 15+ years in configuration, claims, and provider reimbursement. Skilled in stakeholder management, team leadership, and quality control. Known for supporting cross-functional teams, improving processes, and delivering accurate weekly configurations that meet production standards.
Overview
20
20
years of professional experience
Work History
Manager, Configuration
Point32Health
Canton, Massachusetts
09.2020 - 10.2026
- Support team with contract configuration
- Monitor production and quality standards
- Represent team with stakeholders
- Deploy completed configuration designs weekly
- Create job aids
Product Owner I
Point32Health
Canton, Massachusetts
12.2019 - 09.2020
- Create detailed user stories to guide team in configurations needed to fulfill company service requests.
- Quality check to ensure all tasks are completed.
- Assist in PI Planning, Sprint Planning, Demos, and Backlog Grooming.
Supervisor, Provider Reimbursement
Point32Health
Canton, Massachusetts
04.2013 - 12.2019
- Oversee Provider Reimbursement Team contract inventory.
- Ensure configurations are accurate and meet service level agreements.
- Ensure production and quality standards are met monthly.
- Assist in coaching and teaching opportunities for team.
Supervisor, Claims Processing
Point32Health
Canton, Massachusetts
04.2012 - 04.2013
- Oversee claims processing team in claims inventory, processing claims, maintaining work baskets.
- Ensure team production and quality standards are met.
- Invest in coaching and teaching opportunities for team.
Provider Reimbursement Analyst
Point32Health
Canton, Massachusetts
04.2008 - 04.2012
- Contract configuration including professional, facility, Allied, and fee loads.
- Maintain production and quality standards monthly.
Claims Analyst
Point32Health
Canton, Massachusetts
04.2007 - 04.2008
- Analyze claims to ensure accurate data is entered to reflect provider submission with no impact on pricing.
- Maintain production and quality standards.
Skills
- Contract configuration
- Claims processing
- Provider reimbursement
- Stakeholder management
- Quality assurance
- Team supervision
Timeline
Manager, Configuration
Point32Health
09.2020 - 10.2026
Product Owner I
Point32Health
12.2019 - 09.2020
Supervisor, Provider Reimbursement
Point32Health
04.2013 - 12.2019
Supervisor, Claims Processing
Point32Health
04.2012 - 04.2013
Provider Reimbursement Analyst
Point32Health
04.2008 - 04.2012
Claims Analyst
Point32Health
04.2007 - 04.2008