Lysette Rivera
Chicago,IL
Summary
Accomplished Legal Administrative Specialist with a proven track record at the Social Security Administration, enhancing benefit entitlement decisions and financial accuracy. Expert in legal document preparation and bilingual communication, significantly improving client and attorney interactions. Skilled in leveraging technology like PCOM and Epic Programs to streamline processes and ensure regulatory compliance.
Overview
9
9
years of professional experience
Work History
Legal Administrative Specialist
Social Security Administration
08.2018 - Current
- Make final determinations on benefit entitlement decisions.
- Includes having direct telephone contact with the attorneys to resolve discrepancies and provide them with their clients rights under social security laws.
- Adjust established benefits and Effectuating payments. Access and update information about claims using state-of-the-art technology.
- Resolve discrepancies, clarify issues and make determinations on final routes.
- Review Titles II, XVI of the Social Security Act.
- Handled payments with high accuracy and took care to check bills for fraud.
- Identified and resolved discrepancies and errors in customer accounts.
- Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
- Demonstrated to use electronic tools and systems available to organize and process daily work.
- Kept abreast of changes in policy or regulation affecting benefits administration, ensuring continued accuracy in decision-making processes.
Revenue Capture and Financial Specialist
Loyola Medicine
12.2015 - 08.2018
- Enhanced financial decision-making by providing timely and accurate analysis of financial data to executive leadership.
- Collaborated with cross-functional teams to develop strategic plans aligned with overall company objectives.
- Ensured compliance with regulatory standards by conducting regular audits and implementing necessary corrective actions.
- Developed comprehensive financial models for forecasting, budgeting, and performance tracking purposes.
- Optimized working capital management by monitoring accounts receivable/payable balances and negotiating favorable terms with insurance policies.
- Ensured accurate and timely processing of insurance claims dealing directly with insurance companies.
- Followed up on payments from insurance companies and patients due for services.
- Contacted government and third parties for completed insurance claims, payment arrangements, and maintained contact with them until payments were received or issues with payments were resolved.
- Worked directly with patients and their families to ensure all parties understood their benefits and insurance coverage.
- Maintained audits through Ecare and followed up on status daily.
- Responsible for verification, updating, and scanning new patient information.
- Oversaw patient tracking in electronic medical record using CPT-4, ICD-9, and ICD-10 codes.
Education
Associate of Arts - Business Administration
Harry S Truman
Chicago06.2014
High School Diploma -
Pedro Albrizu Campos
Chicago06.2002
Skills
- Bilingual (Spanish)
- Office Administration
- Legal Document Preparation
- Legal Research
- Microsoft Word
- Excel
- Outlook
- Teams
- Social Security applications PCOM
- PolicyNet
- Erps
- Eview
- Ework
- Macade
- Word perfect
- NexGen
- Epic Programs
Timeline
Legal Administrative Specialist
Social Security Administration
08.2018 - Current
Revenue Capture and Financial Specialist
Loyola Medicine
12.2015 - 08.2018
Associate of Arts - Business Administration
Harry S Truman
High School Diploma -
Pedro Albrizu Campos
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