ISIS K. FLORES RIVERA
Sebring,USA
Summary
Dedicated professional focused on continuous learning and skill enhancement with an established company, applying extensive experience and training to foster client satisfaction and streamline the organization's mission.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Revenue Integrity Auditor
Advanced Recovery Systems
Sebring, FL
07.2023 - Current
- Conducted billing audits to improve revenue accuracy.
- Collaborated with teams to ensure compliance with internal controls.
- Provided feedback and training to staff regarding the audit documentation reviewed.
- Performed control audits for revenue cycle functions to ensure controls are designed appropriately, and operating effectively and efficiently.
- Performed audits, ensuring compliance with applicable regulations, and that established policies and procedures are being followed.
- Performed weekly and monthly routine reviews of audit outcomes with the management of assigned projects.
- Identified additional process improvement opportunities and assisted in the redesign of those processes.
- Reviewed policies and procedures for various revenue cycle functions. Provide timely and appropriate feedback to departmental management regarding policies and procedures.
- Applied standard improvement processes and follow-up through (PDCA): Plan, Do, Check, and Act.
- Created and reported an analysis of KPI data to senior management.
- Maintained strict confidentiality; adhered to all HIPAA guidelines and regulations.
- Following all state regulations for development regarding professional licenses.
Telehealth Financial Counselor
Advanced Recovery Systems
Sebring, FL
01.2022 - 06.2023
- Trained staff on financial workflow processes, improving efficiency and accuracy.
- Provided exceptional client service by addressing billing questions and payment plans.
- Assisted upper management, the billing department, and the admissions department with complex financial concerns, ensuring patient accounts were accurately managed.
- Provided clients with detailed assistance on billing questions, payment plans, and client ledgers, showcasing strong communication and problem-solving skills.
- Utilized software such as Microsoft Office 365 and AVATAR to streamline financial processes and improve efficiency with Power BI, Stripe, and Waystar for data analysis.
- Demonstrated a thorough knowledge and understanding of collection policies and procedures, specifically related to co-pays and insurance deductibles, in respect to in-house clients.
- Followed the procedures outlined in 'Collection of Patient Responsibility' to work with the Admissions Department on the solution and collection of agreed funds at the time of admission.
- Responsible for validating patients' benefits using online applications, such as Navinet and Availity.
- Ability to successfully track and follow up on information requests from patients or the Facility Manager.
- Maintained strict confidentiality, and adheres to all HIPAA guidelines and regulations.
- Maintained professional and technical knowledge by attending educational workshops, reviewing professional publications, and establishing personal networks.
- Assisted with billing audits to ensure the accuracy of the patients' accounts.
- Assisted management with process improvement initiatives, and with month-end closing.
Financial Counselor
Advanced Recovery Systems/Next Generation Village
Sebring, FL
06.2015 - 02.2021
- Assisted upper management, the billing department, and the admissions department with complex financial concerns, ensuring patient accounts were accurately managed.
- Provided clients with detailed assistance on billing questions, payment plans, and client ledgers, showcasing strong communication and problem-solving skills.
- Utilized software such as Microsoft Office and AVATAR to streamline financial processes and improve efficiency.
- Demonstrated a thorough knowledge and understanding of collection policies and procedures, specifically related to co-pays and insurance deductibles, in respect to in-house clients.
- Followed the procedures outlined in 'Collection of Patient Responsibility.'
- Worked with the Admissions Director on the solution and collection of agreed funds at the time of admission.
- Responsible for validating patients' benefits using online applications, such as Navinet and Availity.
- Submitted the weekly deposit reconciliation to the local facility designee, or Revenue Cycle Management.
- Assisted management with process improvement initiatives, and month-end closing.
- Ability to successfully track and follow up on information requests from patients or the Facility Manager.
- Maintained the strictest confidentiality; adheres to all HIPAA guidelines and regulations.
- Maintained professional and technical knowledge by attending educational workshops, reviewing professional publications, and establishing personal networks.
- Responsible for maintaining petty cash funds with the necessary supporting documentation.
- Responsible for collecting vendors' supporting documentation in order to process purchase orders for all departments.
Budget Analyst/Contract Manager
Florida Department of Health-Highlands County
Sebring, FL
06.2008 - 11.2013
- Managed an operating budget of $7.5 million to $11.5 million, providing financial guidance to program managers and directors.
- Advised on maximizing the use of local, state, and federal funds to support specific program scopes.
- Analyzed and audited budget reports to make recommendations for the agency's benefit.
- Analyzed and audited local contracts with the agency to check for key provisions and regulations, to ensure that all parties and programs understand and follow them.
- Utilized software such as Microsoft Office and Florida Accounting Information Resource (FLAIR) to streamline financial processes and improve efficiency.
- Developed and implemented processes to improve budget management efficiency.
- Created and reported an analysis of KPI data to senior management.
- Maintained strict confidentiality; adhered to all HIPAA guidelines and regulations.
- Maintained professional and technical knowledge by attending educational workshops, reviewing professional publications, and establishing personal networks.
- Participated in professional societies.
Education
Business Administration - Accounting
University of Ana G. Mendez
Gurabo, PR01.2003
Skills
- Analytical and critical thinking
- Audit procedures and compliance
- Budget Analysis
- Client ledger review
- Compliance auditing
- Data analysis and reporting
- Excellence in Customer Service
- Financial counseling and planning
- Interpersonal communication
- Multitasking Abilities
- Problem-solving and decision-making
- Process improvement and efficiency
- Remote assistance and training
- Software proficiency: Windows 11 Pro, Microsoft Office, Adobe Acrobat Pro DC
- Spending plan preparation
- Strict confidentiality maintenance: HIPAA
- Team collaboration and communication
- Time management and organization
- Training staff
Certification
- Contract Management Re-Certification, Florida Department of Health, 09/01/13
- Basic Interpreter Training, Language Line University, 07/01/13
- Leadership Development Course, DWB Associates, 01/01/12
- Florida Accounting Information Resource (FLAIR) Basic, Revenues and Expenses, Florida Department of Financial Services, 02/01/11
Languages
Spanish
Native/ Bilingual
English
Full Professional
References
References available upon request.
Timeline
Revenue Integrity Auditor
Advanced Recovery Systems
07.2023 - Current
Telehealth Financial Counselor
Advanced Recovery Systems
01.2022 - 06.2023
Financial Counselor
Advanced Recovery Systems/Next Generation Village
06.2015 - 02.2021
Budget Analyst/Contract Manager
Florida Department of Health-Highlands County
06.2008 - 11.2013
Business Administration - Accounting
University of Ana G. Mendez
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