Daira Lopez-Delgado
Rowland Heights,CA
Summary
Seeking the opportunity to best utilize my current skills and experiences, while continuing to grow professionally and personally, accepting new challenges through learning new skills. Highly motivated and goal-driven Financial Analyst skilled in collecting, monitoring and studying data to analyze financial status and recommend business strategy. Experienced in qualitative and quantitative analysis, contract management and forecasting. Tech-savvy in use of spreadsheets, accounting and financial management software. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
19
19
years of professional experience
Work History
Financial Analyst III – Shared Risk
L.A. Care Health Plan
01.2017 - 01.2023
- Execute calculations, analyze data, perform general ledger reconciliation, prepare monthly Journal Entries as well as complete monthly management financial reports, audit reports, and provider monthly statement reports for internal and external publication
- Maintain Shared Risk rate tables to ensure proper monthly calculations
- Work closely with internal departments and management to ensure proper Risk Adjustment Factor (RAF) rates have been applied and perform retro adjustments, as necessary
- Examine individual provider Division of Financial Responsibility (DOFR) updating database claim stamping process as needed
- Analyze and reconcile data received from third party overpayment recovery vendor Health Management Systems, Inc
- (HMS), creating monthly Journal Entries to allocate fund to correct General Ledger accounts.
- Streamlined financial reporting for better decision-making with clear, concise analysis and presentation.
- Facilitated smooth month-end close processes by efficiently reconciling accounts and addressing discrepancies promptly.
- Played a key role in annual audits by preparing detailed schedules, supporting documentation, and assisting auditors throughout the process.
- Created and maintained precise and accurate models, charts and reports.
- Assisted in preparation of presentations, data tables and other documents for investor meetings.
Financial Analyst III – Revenue
L.A. Care Health Plan
01.2015 - 01.2017
- Analyzed and Reconciled daily QNXT cash payments
- Retrieved daily reports from various sources and ensured reports were current and accurate
- Prepared month-end reporting and reconciliation
- Worked in partnership with internal departments as well as external individuals to ensure proper data is being reported
- Directed reconfiguring of companywide Employer Groups development, designing a uniformed format pattern which allowed consistency for database use and reporting
- Created training material as well as led required cross-training
- Performed Daily and Month-end Reconciliation of Bank reports, ensuring premium payments are allocated correctly
- Responsible for monthly member communications such as Grace Period letters, Disenrollment letters and Monthly Invoicing
- Ensured accuracy and eligibility status was up to date, while working in partnership with various internal departments ensuring proper data is being reported.
Financial Analyst
L.A. Care Health Plan
01.2011 - 01.2015
- Analysis and reconciliation of Monthly Broker Compensation, working closely with various departments to ensure the accuracy of data
- Prepared supporting documentation for payments and provided comprehensive statements
- Researched inquiries received as well as prepared any reports required
- Managed the recovery of Stop Loss claims reporting
- Analyzed financial reports and research to find fund recovery opportunities
- Collaborated with Claims Department to ensure needed documents are obtained
- Confirmed funds have been appropriately recovered and create proper journal entry for fund allocation to proper General Ledger
- Analyzed and reconciled the weekly Beacon Mental Health Fee for Service Claims invoice
- Reconciled payments for eligible enrollees; identified duplicate claims as well as overpayments
- Coordinated with General Accounting to ensure payments were made on time
- Managed Centers for Medicare & Medicaid Services (CMS) Plan to Plan reconciliation and attestation process
- Discovered fund recovery opportunities related to the transfer of Special Needs Plans (SNP) enrollment to and from CMS health plans.
Medical Payment Associate/ Recovery Coordinator
L.A. Care Health Plan
01.2008 - 01.2011
- Coordinated process for annual 1099 and 1095-B IRS tax forms
- Verified procedures, performed audits, analyzed, and reconciled reporting data as well as confirmed compliance with IRS deadlines and regulations
- Researched internal or external inquiries
- Coordinated with multiple departments to assure provider’s information is accurate
- Served as liaison with IRS Reporting vendor to ensure an open line of communication is always active ensuring all parties’ needs are met, and made sure contracts are up to date and invoices paid accordingly
- Properly archived copies of provider contracts
- Distributed materials and deliverables to proper analyst promptly requiring having a close relationship with other internal departments
- Processed claim refunds, allocating funds to General Ledger accounts via monthly Journal Entries
- Worked closely with Human Resources to coordinate interviews
- Filled out appropriate forms, contacted candidates and/or agencies for interviews
- Kept an up-to-date record of all documents, candidates, and interview
- Assisted Management with daily responsibilities, coordinated interdepartmental communications as well as the department member’s efforts in accordance with management directions
- Administrative responsibilities included but not limited to training, attestations, expense reimbursements, travel arrangements, maintain department organizational chart, departmental production calendars, month-end copying and distribution of departmental Financial Activity reports, coordinate intradepartmental deliverables and Monitor statuses of project deliverables as well as handle confidential tasks as needed.
Management Associate
L.A. Care Health Plan
01.2007 - 01.2008
- Assistant to the Manager and Director of Information Systems Technology & Security and other I.S
- Associates with their daily responsibilities and duties.
- Managed cross-functional teams effectively, fostering collaboration and communication towards achieving common objectives.
- Streamlined operations by implementing efficient management strategies and workflow processes.
Administrative Secretary
L.A. Care Health Plan
01.2004 - 01.2007
- Assistant to three Managers in the Member Services Department
- Organized reporting and resources among three people, in addition to assisting with company front desk responsibilities.
- Enhanced office efficiency by organizing and maintaining filing systems, managing correspondence, and scheduling appointments.
- Supported executive decision-making by preparing agendas, taking minutes during meetings, and distributing relevant information.
- Streamlined communication channels for optimal productivity, coordinating between departments and liaising with external stakeholders.
- Facilitated interdepartmental collaboration by establishing effective lines of communication between team members and leaders.
- Contributed to a positive work environment by demonstrating professional etiquette in all interactions with colleagues and clients alike.
- Assisted in the development of policies and procedures to streamline administrative processes for improved efficiency.
Education
Bachelor of Arts - Sociology
California State University - Los Angeles
Los Angeles, CAAssociate of Arts - Child Development
East Los Angeles College
Monterey Park, CAMBA - Business
California State University - San Bernardino
San Bernardino, CASkills
- Strong analytical, problem solving, accounting, organizational, and communication skills
- Quick learner
- Ability to work independently, as well as in a team
- Excellent multi-tasking skills
- Knowledgeable in Microsoft Suite (Word, Excel, Visio, Power Point & Publisher), Microsoft Access, Structured Query Language (SQL), Microsoft Dynamic SL, Outlook, E-Copy, MHC, QNXT and SAP
- Comparative Analysis
- Account Reconciliation
- Report Preparation
- Data Analysis
- Variance Analysis
- Project Management
- Report Generation
- Administrative Support
- Research Abilities
- Developing Solutions
- Financial Management
- Analyzing Performance
- Strong Organization
- MS Office Suite
- Research and Data Analysis
- Financial Statements Expertise
- Advanced Computer Skills
- Analytical Research
- Documentation Skills
- Excellent Attention to Detail
- General Ledger Accounting
- Report Creation
- Finance
- Data Collection & Research
- Compiling Data
- Advanced Financial Analysis
- Financial Software
- Microsoft Excel
- Financial Statement Analysis
- Accounting Principles
- Financial Reporting
- Regulatory Compliance
Languages
Spanish
Native or Bilingual
English
Native or Bilingual
Timeline
Financial Analyst III – Shared Risk
L.A. Care Health Plan
01.2017 - 01.2023
Financial Analyst III – Revenue
L.A. Care Health Plan
01.2015 - 01.2017
Financial Analyst
L.A. Care Health Plan
01.2011 - 01.2015
Medical Payment Associate/ Recovery Coordinator
L.A. Care Health Plan
01.2008 - 01.2011
Management Associate
L.A. Care Health Plan
01.2007 - 01.2008
Administrative Secretary
L.A. Care Health Plan
01.2004 - 01.2007
Bachelor of Arts - Sociology
California State University - Los Angeles
Associate of Arts - Child Development
East Los Angeles College
MBA - Business
California State University - San Bernardino
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