Summary
Overview
Work History
Education
Skills
Languages
Diversity and Inclusion
Timeline
Hi, I’m

Gabriela Rand

Summary

Dedicated and results-driven Revenue Cycle Supervisor with 8+ years of experience in overseeing and optimizing financial operations in the healthcare industry. Proven success in streamlining processes, reducing costs, and maximizing revenue generation. Adept at leading and motivating high-performing teams to achieve goals and deliver exceptional results. Expertise in implementing innovative strategies and leveraging technology to enhance efficiency and accuracy throughout the revenue cycle. Strong analytical skills combined with a keen attention to detail to identify and resolve issues, ensuring compliance with regulations and industry best practices. Exceptional interpersonal and communication abilities to foster collaborative relationships with cross-functional teams and external stakeholders.

Overview

14
years of professional experience

Work History

Valley View Hospital Association

Revenue Cycle Manager
08.2018 - Current

Job overview

  • Led enrollment process for new clinics, ensuring compliance with billing requirements and obtaining necessary NPI numbers.
  • Managed provider data and contract participation, improving accuracy and efficiency by implementing spreadsheets and reports to track enrollment timelines.
  • Created training materials for clinic directors and managers, enabling them to stay updated on payer procedures and billing network participation.
  • Completed Medicaid and Medicare revalidation for all providers in the hospital and clinics.
  • Facilitated inter-departmental communication on payer information, billing, and regulations.
  • Successfully completed applications for new providers at various stages of enrollment with commercial and government payers.
  • Achieved less than 0.1% claims held for enrollment errors for the past 5 years.
  • Negotiated favorable reimbursement rates with payers, resulting in a 10% increase in revenue for the organization.
  • Implemented streamlined processes and best practices, reducing average days in accounts receivable by 15%.
  • Developed and implemented a comprehensive payer training program for registrars, reducing insurance entry errors by 20%.

Valley View Hospital Association

Revenue Cycle Supervisor
08.2014 - 08.2018

Job overview

  • Revision of denied claims and identification of trends and patters in billing issues
  • Completed all appeals
  • Analyzed claims in over paid status and contacted the insurance companies to review the steps required to initiate the refund
  • Generated all documentation needed to issue a patient or insurance refunds
  • Documented the claim and the patients file and printed all the documentation to submit to the accounting department.

Valley View Hospital

Accounts Receivable Specialist
08.2012 - 08.2014

Job overview

  • Obtained insurance benefits and coverage for patients who were scheduled for surgeries, procedures, high tech imaging and infusions
  • Used those benefits to generate estimates for patients
  • Submitted prior authorization requests to the insurance companies with the pertinent medical records
  • If a peer to peer review was needed for approval I would facilitate communication between the physician and the insurance company.

Matthew L. Goodstein

Pre-Certification Specialist and Registrar
05.2009 - 08.2012

Job overview

  • Handled all front desk duties
  • Generated a report of patients who needed phone calls due to aging accounts and set up payment plans as needed
  • Translated office visits and patient documents for all Spanish-speaking patients

Education

Colorado Mountain College
Glenwood Springs, CO

Bachelor of Science from Business Administration

University Overview

Graduated with honors

  • Private Donor Scholarship Recipient
  • 3.8 GPA
  • magna cum laude graduate

Colorado Mountain College

Associate of Arts from Business

University Overview


  • Alpine Bank Hispanic Scholarship Recipient
  • 3.9 GPA
  • Ranked in Top 10% of class
  • Phi Theta Kappa Member


Southern New Hampshire University

Master of Science from Business
09.2026

University Overview

Skills

  • Athena Market Implementation
  • Provider Enrollment- Multi-State
  • Medical Claims Review and Auditing
  • Athena billing mapping
  • Conceptual Thinking
  • Inductive Reasoning
  • Microsoft office
  • Excel reporting, pivot tables, formulas
  • Streamlining
  • Troubleshooting
  • Microsoft Office

Languages

Spanish
Native or Bilingual

Diversity and Inclusion

Diversity and Inclusion

 

  • Hispanic Heritage: Proudly embrace my Hispanic cultural background and offer a diverse perspective.
  • Spanish Language Proficiency: Fluent in Spanish, both written and spoken. Able to effectively communicate and collaborate with Spanish-speaking individuals.
  • Community Involvement: Actively participate in local Hispanic community events, festivals, and cultural organizations. Advocate for the celebration and understanding of diverse cultures.
  • Cultural Sensitivity: Demonstrate a deep respect for cultural differences, fostering an inclusive and welcoming environment for colleagues and diverse teams.

Timeline

Revenue Cycle Manager
Valley View Hospital Association
08.2018 - Current
Revenue Cycle Supervisor
Valley View Hospital Association
08.2014 - 08.2018
Accounts Receivable Specialist
Valley View Hospital
08.2012 - 08.2014
Pre-Certification Specialist and Registrar
Matthew L. Goodstein
05.2009 - 08.2012
Colorado Mountain College
Bachelor of Science from Business Administration
Colorado Mountain College
Associate of Arts from Business
Southern New Hampshire University
Master of Science from Business

Similar Profiles

CREATE PROFILE
Gabriela Rand