Summary
Overview
Work History
Education
Skills
Timeline
Generic

Karla Guendulay Rivera

Fort Dodge,IA

Summary

Dependable and motivated bilingual healthcare administrative professional with over 6 years of experience in patient services, credentialing, insurance verification, and office operations. Proven ability to manage credentialing processes across multiple insurance panels, streamline office workflows, and maintain patient satisfaction. Fast learner with strong communication, multitasking, and problem-solving skills.

Overview

9
9
years of professional experience

Work History

Business Development Representative

Kemna Auto Of Fort Dodge
Fort Dodge , Iowa
08.2018 - 06.2021
  • Handling incoming calls and following up on customer visits
  • Responding to Internet lead requests
  • Setting appointments for test drives
  • Following up with past customers and maintain relationship
  • Forward customer concerns to the proper Department manager for follow up
  • Use Microsoft Excel / Outlook daily to track numbers for the CRM
  • Translator ( when needed)

Receptionist Administrator

Liguria Foods
10.2022 - 03.2024
  • Greeted and assisted all visitors and staff, managing the front office with professionalism and efficiency
    Translated documentation and in-person communications for Spanish-speaking employees
    Coordinated incoming and outgoing mail, parcels, and scheduled carrier pickups
    Partnered with HR to process new hire paperwork, update personnel files, and moderate orientation sessions
    Managed employee time-off requests and communicated updates at weekly staff meetings
    Maintained employee records related to payroll and benefits with strict confidentiality
    Operated multi-line phones, copied and scanned important documents, and generated reports in Excel

Patient Experience Specialist

UnityPoint Health
07.2021 - 09.2022
  • Welcomed and checked in patients, verified insurance and demographics, and collected copayments at the time of service
  • Used EPIC to update medical records, schedule/reschedule appointments, and track provider availability
  • Maintained smooth patient flow by coordinating communication between patients, therapists, and staff
  • Verified coverage and submitted claims as needed; input ICD-10 medical codes for billing accuracy
  • Monitored office and clinical supply inventory and placed orders to maintain stock
  • Served as in-house Spanish translator for patient communication and documentation
  • Ensured compliance with HIPAA policies and maintained patient confidentiality at all times

Clinic Coordinator

Axis Therapy Centers
03.2024 - Current
  • Greet patients and families, manage check-ins and check-outs, and answer multi-line phone system
  • Respond to voicemails and emails in a timely and professional manner
  • Maintain a clean, organized, and welcoming clinic environment
  • Coordinate therapist schedules and room usage to optimize patient flow
  • Monitor clinic supplies and manage restocking and vendor deliveries
  • Obtain and verify insurance coverage and eligibility prior to appointments
  • Confirm deductible, co-pay, coinsurance, and authorization requirements with payers
  • Communicate benefits information clearly to families and staff
  • Collect and input accurate patient demographic and insurance information into the EMR
  • Submit and track authorizations for evaluations and ongoing therapy services
  • Flag and follow up on expired authorizations or coverage changes
  • Work closely with billing specialists to address claim denials and resolve insurance issues
  • Assist patients with billing and insurance-related questions
  • Review and correct rejected claims due to insurance data errors

Credentialing & Provider Enrollment

  • Prepare and submit initial credentialing and recredentialing applications for providers
  • Track application status and maintain ongoing communication with insurance companies and payers
  • Maintain organized credentialing files with up-to-date licenses, CAQH, NPI, liability insurance, and other required documents
  • Follow up with providers for missing information or expiring documentation
  • Ensure timely enrollment with Medicaid, Medicare, and commercial payers to prevent billing delays
  • Update credentialing spreadsheets or software regularly to track progress and renewal deadlines

Customer Service Advisor

Mister Car Wash
06.2016 - 07.2017

Education

High School Diploma -

Webster City High School
Webster City, IA
05.2016

Skills

  • Bilingual
  • Problem-solving
  • Time management
  • Fast Learner
  • Knowledgeable with Microsoft
  • Great communication skills
  • Multitasker

Timeline

Clinic Coordinator

Axis Therapy Centers
03.2024 - Current

Receptionist Administrator

Liguria Foods
10.2022 - 03.2024

Patient Experience Specialist

UnityPoint Health
07.2021 - 09.2022

Business Development Representative

Kemna Auto Of Fort Dodge
08.2018 - 06.2021

Customer Service Advisor

Mister Car Wash
06.2016 - 07.2017

High School Diploma -

Webster City High School
Karla Guendulay Rivera