Jane Vergara Rivera
Lynnwood
Summary
Detail-oriented professional with proven expertise at Overlake Hospital Medical Center, adept at data verification and quality control. Demonstrates strong analytical, communication, and teamwork skills, with proven ability to quickly adapt to new environments. Eager to contribute to team success and further develop professional skills. Brings positive attitude and commitment to continuous learning and growth.
Overview
19
19
years of professional experience
Work History
Clinical Data Abstractor
Overlake Hospital Medical Center and Clinics
03.2017 - 09.2025
- Input data into the Infosario Registry Platform for Heart Failure.
- Followed exact procedures based on GWTG (Get with the Guidelines) Heart Failure Registry.
- Reviewed Heart Failure medical records and mined specific data with accuracy.
- Utilized electronic medical record systems to retrieve and process patient data onto the HF Registry.
- Monitored HF registry by providing fallout review audits, uploaded abstracted data to Registry and generated performance improvement measures when needed.
- Identified new data elements for automating abstraction.
Patient Financial Services Representative/Insurance Claims Specialist
Overlake Hospital Medical Center and Clinics
03.2007 - 03.2017
- Maintained accurate records of customer accounts, insurance payments and insurance payment plans.
- Researched billing errors and discrepancies to initiate corrective action.
- Listened to customers- both insurance reps and patients- by investigating and resolving medical claims issues.
- Responded timely to customer inquiries and provided detailed information.
- Entered client details and notes in EPIC system for interdepartmental access and review.
- Evaluated and settled complex insurance claims in strict timeframes.
- Followed up with customers on unresolved issues.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Generated, posted, and attached information to claim files.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Coordinated with contracting department to resolve payer issues.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Communicated effectively with finance, coding, and clinical departments.
- Prepared insurance claim forms or related documents and reviewed for completeness.
Education
Bachelor of Arts - Sociology
University of Washington
Seattle, WA06-1996
Skills
- Patient confidentiality
- Medical billing
- Quality control procedures
- Medical terminology proficiency
- HIPAA compliance
- Adaptability
- Task prioritization
- Excellent communication
- Data verification
- Detail-oriented
- Reliability
- Time management abilities
Timeline
Clinical Data Abstractor
Overlake Hospital Medical Center and Clinics
03.2017 - 09.2025
Patient Financial Services Representative/Insurance Claims Specialist
Overlake Hospital Medical Center and Clinics
03.2007 - 03.2017
Bachelor of Arts - Sociology
University of Washington
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