Leticia Rivera
Fresno,CA
Summary
Reliable Claims Examiner experienced in medical claims processing and customer service. Delivered effective support in monitoring patient conditions and assisting with daily living activities while managing multiple tasks in fast-paced environments. Focused on contributing to team success and enhancing overall service quality.
Overview
4
4
years of post-secondary education
27
27
years of professional experience
Work History
Caregiver
IHSS
01.2016 - 08.2026
- Assisted clients with daily living activities and personal care tasks.
- Provided companionship and emotional support to enhance client well-being.
- Monitored patient health status to detect changes and ensure timely interventions, Prepared meals according to dietary guidelines, Recorded patient medication administration times, Transported patients to medical appointments, providing support and companionship
- Managed medication schedules and reminders for clients.
- Coordinated transportation for appointments and community activities.
Caregiver
IHSS Adult Services Program
Fresno, California
03.1999 - 09.2006
- Assisted clients with daily living activities and personal care needs.
- Provided assistance to clients with daily living tasks with daily living activities and personal care needs.
- Provided companionship and emotional support to enhance client well-being.
- Monitor Patients' Condition, Prepared nutritious meals tailored to patients' dietary needs, Monitored medication schedules to ensure adherence and prevent complications, Assisted patients with transportation to doctor visits..
Claims Examiner
Western Growers
Fresno, CA
12.2006 - 08.2015
- Reviewed insurance claims for accuracy and completeness.
- Analyzed claim documents using company software tools.
- Collaborated with healthcare providers to clarify claim details.
- Processed medical, dental, and vision claims. Processed correspondence mail in a timely manner. Answer customer service calls, Entered medical claims into the database accurately. Reprocess medical tracers, forward claims to medical review for approval on claims.
Claims Examiner
Cigna Healthcare
Irvine, CA
09.1999 - 09.2006
- Processed medical and dental claims and correspondence mail promptly.
- Interpreted policy language to determine claim eligibility.
- Communicated with clients to gather necessary documentation.
- Process medical and dental claims, process correspondence mail received in a timely manner. Reprocessed denied claims to provide clear explanations of medical benefits. Entered data into systems accurately paper medical claims, Processed refund and return requests checks processor.
Education
High School Diploma - General Education
Edison High School
Fresno, CA 06.1984 - 06.1988
Skills
- Monitor patient health
- Medication monitoring
- Nutritional Meal Planning
- Doctor visit assistance
- Patient Record Management
- Client Support Communication
- Client Communication Management
- Patient Insurance Coordination
- Claim Review Coordination
- Claim Approval Facilitation
- Dental Benefits Support
- Vision Care Assistance
- Financial Transaction Management
Timeline
Caregiver
IHSS
01.2016 - 08.2026
Claims Examiner
Western Growers
12.2006 - 08.2015
Claims Examiner
Cigna Healthcare
09.1999 - 09.2006
Caregiver
IHSS Adult Services Program
03.1999 - 09.2006
High School Diploma - General Education
Edison High School
06.1984 - 06.1988