Flora Rivera

• Administrative (20%)
  • Ability to cross train to perform all duties of the SHS Medical
  • Train all new Health and Counseling staff on office and university functions, as well as
  put in all requests for required access pertaining to the position
  • Prepares and submits monthly/annual health and counseling clinic utilization statistics
  • Serves as the primary liaison with equipment software service vendors
  • Documents patient information clearly and accurately; communicates effectively with the
  staff to maximize patient care
  • Demonstrates patient advocacy assuring patients' rights to privacy, safety and
  confidentiality by adhering to HIPAA and FERPA guidelines.
  • Using pre-established protocols, determine if patient health care needs (either walk-in or
  by telephone) require immediate or urgent assessment (Training)
  • Effectively communicates on the phone and in person, transmitting all information to
  patients, and staff in an attentive, prompt and polite manner
  Budget Management (20%)
  • Monitors monthly collections/accounts receivable goals; maintains daily money charges,
  balancing and deposits
  • Pays all incoming invoices for SHS/Counseling.
  • Manages departmental budget and tracks expenditures
  • Tracks all medications distributed to Anthem BCBS Student Health patients and transfers
  funds from 43 account.
  • Tracks and prepares expenditure transfer form for Study Abroad physicals
  • Removes all fees from Image Now for withdrawals.
  Financial Reports for Billing and Insurance (20%)
  • Prepare claims to submit to both primary and secondary insurance companies for
  payments on client accounts
  • Prepare statements to submit to clients for unpaid balances
  • Relate needed information to client and /or insurance companies regarding accounts
  • Contact insurance companies in an effort to collect submitted client claims
  • Resubmit information required by insurance companies in order to process claims and
  appeal denial if needed
  • Post insurance payments entering contractual allowances where necessary
  • Transmit electronic claims
  • Writes-off uncollectible accounts receivable in accordance with the Regis University
  policy
  • Monitors tracking, billing and bookkeeping of IOU and self-pay revenue
  • Coordinate as needed with health insurance carrier, Office of Admissions, insurance
  broker/mediator and various departments in Regis College and RHCHP
  • Prepare and split combined SHS and Regis Neighborhood Health check deposits
  Student Health Insurance Program (SHIP) (40%)
  • Pull Report from the “Good INS Report” and download, (this is a list of all eligible
  students that require student health insurance per their program).
  • Copy and paste report to an excel spreadsheet to update daily as students enroll/waive on
  GSH web portal.
  • Send Eligible Students Reporting to Gallagher Student Health to send out
  communications to all students as a reminder to waive/enroll in the SHIP when the portal
  opens.
  • Send out communication to all our students as well from the ship@regis.edu email
  address to waive/enroll.
  • Put charges on all student’s account in Colleague.
  • Pull report from Gallagher Student Health’s website on students that waived and remove
  the charges on student’s acct via Colleague on a daily basis and mark on excel
  spreadsheet.
  • Pull report from Gallagher Student Health’s website on students that enrolled and mark
  on excel spreadsheet, must make sure HI is billed on their account in Colleague to
  reconfirm. If a student enrolled but is not in the excel spreadsheet but is on GSH report,
  must confirm they are eligible and if not, let GSH know and contact student via email
  they are not eligible for HI and must look for other options. Assist if needed to help
  locate a plan for them.
  • Pull report from GSH of students that waivers have been denied, pending information and
  help fix their accounts for resubmission.
  • Also marks on the excel spreadsheet of students that have waived and enrolled to keep a
  log.
  • Pull Report from Image Now and mark on the spreadsheet of students who have
  withdrawn from RU and remove the SHIP fee from their account in Colleague.
  • Communicate with GSH rep on a daily basis of updates, adds, removals and errors on
  student’s accounts.
  • Work with customer service team at GSH on students who have filled in a “Petition to
  Add” form for students, verify eligibility, add charges to account in Colleague and mark
  on spreadsheet.
  • Communicate on a daily basis with students/faculty and staff regarding the student health
  insurance on the ship@regis.edu email.
  • Sends out continuous emails to students waive/enroll before the deadline then after the
  deadline regarding the extended deadline.
  • Work with Students Accounts dept on waivers or students’ questions.
  • On the final deadline, mark on the excel spreadsheet the rationale for why students that
  have not waived or enrolled.

Clerical/Administrative (20%) • Ability to cross train to perform all duties of the SHS Medical Administrative Assistant and the OCPD Administrative Assistant in his or her absence • Prepares and submits monthly/annual clinic utilization statistics for Director • Effectively communicates on the phone and in person, transmitting all information to patients, and staff in an attentive, prompt and polite manner • Serves as the primary liaison with equipment and medical software service vendors • Documents patient information clearly and accurately; communicates effectively with the staff to maximize patient care • Demonstrates patient advocacy assuring patients' rights to privacy, safety and confidentiality by adhering to HIPAA and FERPA guidelines • Using pre-established protocols, determine if patient health care needs (either walk-in or by telephone) require immediate or urgent assessment • Collects insurance co-payments at the time of service • Performs all other duties as assigned by the Director • Provides secretarial support for the Director Budget Management (30%) • Monitors monthly collections/accounts receivable goals; maintains daily money charges, balancing and deposits • Pays all incoming invoices • Manages departmental budget and tracks expenditures • Tracks all medications distributed to Aetna Student Health patients and transfers funds from 43 account • Prepare expenditure transfer forms for Regis Neighborhood Health reimbursement • Tracks and prepares expenditure transfer form for Study Abroad physicals • Prepares and submits monthly/annual accounts receivable financial reports for Director Billing and Insurance (50%) • Prepare claims to submit to both primary and secondary insurance companies for payments on client accounts • Prepare statements to submit to clients for unpaid balances • Relate needed information to client and /or insurance companies regarding accounts • Contact insurance companies in an effort to collect submitted client claims • Resubmit information required by insurance companies in order to process claims and appeal denial if needed • Post insurance payments entering contractual allowances where necessary • Transmit electronic claims • Writes-off uncollectible accounts receivable in accordance with the Regis University policy • Monitors tracking, billing and bookkeeping of IOU and self-pay revenue • Oversees administrative responsibilities for the student health insurance program • Coordinates as needed with health insurance carrier, Office of Admissions, insurance broker/mediator and various departments in Regis College and RHCHP • Ensures services are in place for eligible students and coordinates all correspondence, eligibility confirmations and the insurance waiver program • Responsible for daily verification of insurance coverage • Prepare and split combined SHS and Regis Neighborhood Health check deposits

Authorizations Specialist for all medical insurance companies for 4 different companies with 7 Sleep Study Locations

Posted and adjusted payments from insurance companies for all locations.

Insurance verification specialist with all major medical insurances and verified eligibility and benefits and out of pocket information for our patients.

Adeptly managed a multi-line phone system assisted patients with benefit questions and out of pocket information.

Researched questions and concerns from office staff regarding patient accounts and provided detailed responses and quickly responded to emails in a timely manner concerning patients