Maite Garcia Rivera
Land O' Lakes,FL
Summary
Results-driven leader with a focus on problem-solving and administrative excellence. Skilled in managing teams and improving operational workflows, leading to increased efficiency. Committed to fostering a cooperative atmosphere that aligns team efforts with organizational goals.
Overview
36
36
years of professional experience
Work History
Supervisor- Central Processing Department
Genex Services, LLC
01.2022 - Current
- Develop, motivate, evaluate and coach employees on regulatory compliance, work procedures and protocols, proper call handling and teamwork to fulfill customer needs and achieve business success with excellent customer service.
- Analyze productivity data to identify barriers to job performance and assess individual and team performance to provide candid and timely feedback regarding employees developmental and training needs.
- Develop and maintain strong collaborative relationships with internal and external contacts to maintain clear, concise lines of communication as a means to share resources, meet customer needs and fulfill business objectives.
- Immediately resolve claim inquiries by identifying problems and challenges, obtaining applicable information, perform root cause analysis and generating actionable, effective solutions.
- Serve as liaison between staff and other areas including management, customers and provider teams to communicate workflow results, new ideas and creative solutions.
Supervisor of Operations
Coventry Health Care
05.2017 - 01.2022
- Lead a staff of 15 employees to achieve daily production, quality and operation goals.
- Train staff, assign work, and assist with field questions.
- Assist in resolving questions on outstanding billing, reporting and claim related issues in order to meet the departmental quotas and quality goals.
- Managed and oversaw the entry submission of billing activities within designated monthly cutoff time as well as reconciled the adjustment, credit and rebilling of invoices to guarantee the accurate and timely billing of servies rendered.
Senior Service Operations Specialist
Coventry Health Care
12.1998 - 05.2017
- Assisted management team with testing system for the fee schedule accuracy.
- Verified fee scheduled, CPT, and PPO applications processed by analysts.
- Applied insurance carriers account specifications to claims.
- Utilized state workers compensation fee schedules and CPT guidelines to ensure proper billing practices.
- Researched, assessed and resolved outstanding billing, reporting and claim related issues while meeting and exceeding individual production quotas and quality goals.
- Received incoming customer service and provider inquiry calls.
- Implemented, integrated and managed compliance with all functions and workflows of Field Case Management Operations impacting the timely reporting and assignment of Finance projects.
Review Services
KePRO South Inc
04.1995 - 11.1998
- Investigated, assessed and compiled Medicaid clinic data for nursing reviews, in addition to data entry and researching correspondence from different providers.
- Self-motivated, with a strong sense of personal responsibility.
Service Order Coordinator
Sprint Publishing & Advertising
08.1989 - 02.1995
- Accountable for processing 12,000 customer service advertising accounts worth $9 million.
- Processed advertisement for Florida industries which resulted in error free telephone directories.
- Adhered to production schedule, researched projects, received, distributed and logged daily work flow.
- Communicated changes with telephone company to accurately key accounts.
Education
High School -
Jefferson High School
Tampa, FloridaSkills
- Process improvement
- Quality control
- Prioritization
- Research
- Set objectives
- Train employees
Languages
Spanish
Native or Bilingual
Timeline
Supervisor- Central Processing Department
Genex Services, LLC
01.2022 - Current
Supervisor of Operations
Coventry Health Care
05.2017 - 01.2022
Senior Service Operations Specialist
Coventry Health Care
12.1998 - 05.2017
Review Services
KePRO South Inc
04.1995 - 11.1998
Service Order Coordinator
Sprint Publishing & Advertising
08.1989 - 02.1995
High School -
Jefferson High School
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