Cristina Y. Lopez
Summary
Dedicated candidate aiming for career advancement, committed to applying robust organizational and educational expertise alongside outstanding interpersonal abilities
Overview
19
19
years of professional experience
Work History
Senior Revenue Recovery Specialist
Optum Monarch Healthcare
Irvine, CA
09.2014 - 11.2024
- Perform a variety of tasks related to developing a knowledge-based and understanding of government payer regulations, terms of third-party payer regulations and contracts, coverage and benefit plans, coordination of benefits, payment terms and all other conditions affecting payment, appeal of payment variances and correct payment calculation (i.e. AB1455, A1324, Knox-Keene Act, Health & Safety Codes, etc.).
- Knowledge of networks, IPA' Medicare, Medi-Cal, HMO's, PPO's and PCP's and contract affiliations.
- Managed patient data and claims using EZ-Cap Healthcare system.
- Coordinated patient admissions and verifications, ensuring timely and accurate enrollment in hospice care.
- Maintained accurate and up-to-date records of patient eligibility and verification status.
- Some knowledge of ICD-10, CPT coding, ICD coding.
- Analyze internal processes, technical system issues and payer processing/system issues and determine/communicate corrective actions to resolve payment variances.
- Document appeals of payment variances and reimbursement amounts recovered through the various appeals processes.
- Perform special projects, as assigned, to resolve recovery issues, settlements with payers and optimize revenue recovery.
- Use internal data and systems to identify, document, track and summarize payment variances to determine appropriate actions to be taken to initiate appeals and to address inaccurate reimbursement in a timely manner.
Reception
Monarch Healthcare
Irvine, CA
12.2012 - 09.2014
- Answer telephone, screen and direct calls
- Administer company’s subpoenas and records for legal department.
- Provide information to callers.
- Monitor visitor access and maintain security awareness.
- Provide general administrative and clerical support.
- Receive and sort mail and deliveries.
- Greet people entering organization.
- Process legal certified mail for claims department.
- Process incoming faxes from provider’s office.
- Administer corporate desk security access badges.
- Assist Executive Assistants walking in visitors into conference room.
Administrative Assistant
Apria Healthcare
Irvine, CA
02.2011 - 04.2012
- Assist staff with administrative duties as requested.
- Oversee database management for quality assurance.
- Make outbound calls to doctor’s offices to gather information.
- Inputting patient’s information in the system to process patient’s hospital equipment.
Office Assistant / Receptionist
Pomery Law & Associates
Anaheim, CA
05.2009 - 12.2009
- Answering phone calls, directed calls and took messages.
- Maintain supplies inventory by checking stock to determine inventory level; anticipating needed supplies; placing and expediting orders for supplies; verifying receipt of supplies.
- Compiled, copied, sorted, scanned documents, and filed records.
- Maintain necessary correspondence with clients by keeping them informed about the latest developments regarding the case, and sending across necessary documents via e-mail, fax or post.
Loan Processor Assistant
Home Owners Assistant
Santa Ana, CA
03.2008 - 11.2008
- Approves teacher cancellations; prepares special status on NDEA loan funds.
- Prepare annual reports concerning the status of the loan collection office and uncollectible accounts.
- Analyzes delinquent loans, and determines when legal action must be taken, or collection agencies.
Saturn of Santa Ana
Santa Ana, CA
04.2006 - 12.2007
- Balance cash drawer and receipts; documents discrepancies.
- Count money, give change and issue receipt for funds received.
- Provide administrative support such as answering telephones and assisting visitors.
- Maintain, and update files, databases, records, and other documents.
- Perform general office duties such as typing, scanning, sorting mail, faxing, and filing.
Education
Century High School
Santa Ana, CASkills
- Bilingual: English and Spanish
- Legal research and writing
- Organizational skills
- Microsoft Office proficiency
- Healthcare software expertise
Languages
Spanish
Native or Bilingual
Timeline
Senior Revenue Recovery Specialist
Optum Monarch Healthcare
09.2014 - 11.2024
Reception
Monarch Healthcare
12.2012 - 09.2014
Administrative Assistant
Apria Healthcare
02.2011 - 04.2012
Office Assistant / Receptionist
Pomery Law & Associates
05.2009 - 12.2009
Loan Processor Assistant
Home Owners Assistant
03.2008 - 11.2008
Saturn of Santa Ana
04.2006 - 12.2007
Century High School