CRYSTAL OLIVAS
Fresno Women’s Medical Group
20
years of professional experience
1
Certification
Certified medical billing and physician practice management professional with 18+ years of experience in revenue cycle management, claims adjudication, medical office operations, staff supervision, and patient financial services. Proven ability to manage full-cycle billing, front-desk operations, surgery scheduling, prior authorizations, payroll, accounts payable, provider support, and daily practice administration. Experienced in leading multidisciplinary teams, improving workflows, resolving complex payer issues, identifying revenue leakage, and maintaining regulatory compliance. Extensive background in OB-GYN, behavioral health, chiropractic, family medicine, and pediatrics. Proficient in Epic, Intergy, NextGen, PrimeSuite, Availity, QuickBooks, ADP, Paylocity, and payer portals.
Professional with high standards and results-driven approach, prepared for role of Office Manager. Skilled in team collaboration, adaptable to changing needs, and reliable. Proficiencies include administrative management, scheduling, budgeting, and staff coordination. Known for effective communication, problem-solving, and organizational skills.
Work History
Office Manager / Billing Manager
12 Years 9 Months- Direct daily practice management, revenue cycle, and administrative operations for a private OB-GYN practice.
- Supervised, trained, and evaluated 18 employees across billing, front desk, checkout, referrals, scheduling, and clinical support to enhance team effectiveness and service delivery.
- Oversee charge capture, claim submission, payment posting, accounts receivable, insurance follow-up, denials, and patient balances.
- Manage front-desk operations, including patient registration, appointment scheduling, check-in and checkout, insurance verification, copayment collection, telephone support, and patient service.
- Manage accounts payable by reviewing invoices, paying office bills, tracking due dates, and maintaining accurate payment records.
- Process employee payroll, review timekeeping records, verify hours and leave balances, and resolve payroll discrepancies.
- Assist with budgeting, expense monitoring, vendor accounts, financial reconciliation, and QuickBooks processes.
- Audit claims and provider documentation for coding accuracy, compliance, reimbursement, and missed revenue opportunities.
- Monitor external billing company performance, aged claims, unresolved denials, and follow-up activity.
- Managed accounts payable by reviewing invoices, ensuring timely payments, and maintaining accurate records to support financial integrity.
- Develop practice policies, standard operating procedures, employee training materials, and corrective workflows.
- Coordinate provider schedules, staffing coverage, onboarding, employee relations, and performance management.
- Support provider credentialing, payer enrollment, vendor management, and supply purchasing.
- Maintain HIPAA compliance, patient service standards, internal controls, and operational accountability.
- Lead EHR and practice management system transitions involving Epic, Intergy, NextGen, and PrimeSuite.
- Coordinate surgical scheduling with providers, patients, hospitals, and surgical facilities.
- Coordinated provider schedules, staffing coverage, and employee relations to optimize operational efficiency and support practice needs.
- Manage prior authorizations for surgeries, procedures, diagnostic imaging, medications, injections, and other payer-required services.
- Submit clinical documentation, monitor authorization status, respond to payer requests, and escalate or appeal denials when necessary.
- Research payer policies and resolve coding, eligibility, authorization, medical necessity, and timely-filing issues.
Claims Adjudicator / Customer Service Representative
6 Years 7 Months- Adjudicated behavioral health and chiropractic claims according to eligibility, plan benefits, coverage guidelines, and reimbursement policies.
- Applied deductibles, copayments, coinsurance, benefit limitations, and contractual allowances to determine claim payments.
- Processed claim adjustments and resolved denied, rejected, and incorrectly paid claims.
- Assisted members and providers with claim status, benefits, payments, denials, and EOB questions.
- Facilitated resolution of claim inquiries for members and providers regarding status, benefits, payments, denials, and EOB questions.
- Handled high volume of customer service calls, ensuring accuracy and professionalism in responses to inquiries.
- Recorded claim activity, telephone conversations, payment information, and account updates to maintain accurate and accessible records.
- Maintained HIPAA compliance and protected confidential health information.
Education
High School
Skills
Revenue Cycle Management
Medical Billing Operations
Claims Adjudication
Denial Management
Billing management
Payment Posting and Reconciliation
Claims Auditing
Patient registration
Insurance Verification and Benefits
Surgery Scheduling
Insurance verification
Payment reconciliation
Practice Management
Staff Supervision and Training
Staff training
Policy and Procedure Development
HIPAA Compliance
EHR and Practice Management Systems
Epic
Budget monitoring
Payer credentialing
PrimeSuite
Policy development
InstaMed
EHR systems
ADP
Paylocity
Microsoft Office
Vendor Management
Budget and Expense Monitoring
Expense management
Billing Oversight
Payroll Management
Employee Scheduling
Payer Portals
Office management
Payer Portals
Office management
Certification
- Certified Professional Biller — CPB, AAPC
- Certified Physician Practice Manager — CPPM, AAPC
Timeline
Office Manager / Billing Manager
Fresno Women’s Medical Group
11.2013 - CurrentRead More
Claims Adjudicator / Customer Service Representative
Avante Health
02.2007 - 09.2013Read More
McLane High School
High School
Read More