Esther Rivera
Parlin,NJ
Summary
Senior Representative with 5+ years of experience in healthcare benefits coordination and insurance verification. Expertise in leading complex case resolutions and training new hires. Consistently exceeded performance metrics and demonstrated strong leadership capabilities. Aiming to transition into a supervisory role to further utilize skills and experience.
Overview
11
11
years of professional experience
Work History
SR REPRESENTATIVE
CVS Specialty
Orlando, FL
10.2023 - Current
- Assist with training and onboarding support
- Function as peer mentor and knowledge resource, offering guidance on best practices and problem resolution
- Identify trends in errors and collaborate with leadership
- Manage escalated issues from internal teams and clients with professionalism and efficiency
BV REPRESENTATIVE
CVS Specialty
Orlando, FL
07.2021 - 10.2023
- Verified patient insurance eligibility for medications in high volume environment
- Mediated between patients, providers, and insurance companies to obtain authorizations and resolve benefit discrepancies
- Maintained accurate documentation, while ensuring adherence to HIPAA regulations
- Met monthly productivity and accuracy metrics
PROCESSING & INS SPECIALIST
Central Mobility & Rehab Equipment
Tavares, FL
12.2019 - 02.2021
- Received and reviewed DME orders from physicians, case managers, or healthcare providers
- Confirmed prescription details, diagnosis codes, and ensured medical necessity documentation was complete
- Verified patient insurance coverage for DME services, including Medicare, Medicaid, commercial plans, and managed care
A/P SPECIALIST
Wayside Technology Group
Eatontown, NJ
10.2014 - 08.2019
- Reviewed and processed a high volume of invoices for accuracy, approval, and payment
- Maintained vendor records and responded to inquiries regarding payment status or discrepancies
- Reviewed and verified employee expense reports for policy compliance and documentation
- Processed reimbursements and followed up on missing or incorrect information
Education
BA - BUSINESS ADMIN
Strayer University
Herndon, VA03-2028
Skills
- Communication and interpersonal skills
- Cross-functional team development
- Time management and organization
- Team collaboration
- Emotional intelligence and resilience
- Strong work ethic and adaptability
Languages
Spanish
Native/ Bilingual
Timeline
SR REPRESENTATIVE
CVS Specialty
10.2023 - Current
BV REPRESENTATIVE
CVS Specialty
07.2021 - 10.2023
PROCESSING & INS SPECIALIST
Central Mobility & Rehab Equipment
12.2019 - 02.2021
A/P SPECIALIST
Wayside Technology Group
10.2014 - 08.2019
BA - BUSINESS ADMIN
Strayer University