Nuvia Peneyra
Sacramento,CA
Summary
Detail-oriented and certified Healthcare Access and Referral Professional with over 7 years of dedicated experience in financial clearance, care navigation, and patient intake coordination. Expert in managing complex transfer networks, executing prior authorizations, and utilizing Epic, Cerner, and athenalDX platforms. Proven track record in collaborating with cross-functional clinical teams, reducing bottlenecks in care, and ensuring strict HIPAA compliance. Fully bilingual in English and Spanish, offering seamless communication and advocacy for diverse patient populations during critical transitions.
Overview
1
1
Certification
18
18
years of professional experience
Work History
Principal Access Representative
UC Davis Health (Financial Clearance Unit)
Rancho Cordova, CA
01.2026 - 06.2026
- Managed prior authorization workflow from start to finish, verifying complex insurance eligibility and compiling clinical documentation, including CPT/HCPCS codes, lab results, and provider notes for timely review.
- Initiated appeals and arranged peer-to-peer reviews to contest insurance denials, facilitating timely patient care delivery.
- Monitored pending referral and authorization requests in Epic, providing regular updates to providers and patients to ensure transparency and communication.
- Supported financial clearance and entry workflows for specialized medical procedures, helping patients move smoothly into the health system.
Medical Office Representative 2
Dignity Health Medical Foundation (Urgent Care)
Sacramento, CA
02.2023 - 12.2025
- Supported urgent care intake registration and external referrals across multi-payer settings to secure authorization before clinical procedures.
- Reviewed referral and authorization workflows in AthenaLdx and Cerner, identified discrepancies, and corrected issues to facilitate timely care placement.
- Coordinated specialized scheduling and follow-up care for workers' compensation patients, enhancing collaboration with occupational medicine providers.
- Acted as Spanish-bilingual support during medical intake and cross-department coordination, helping physicians capture accurate health history documentation.
- Managed automated workflows and work queues to resolve claim exceptions and copay payer discrepancies, ensuring accurate cash drawer reconciliations.
Claims Processor
Blue Cross Blue Shield of Michigan
McClellan, CA
12.2018 - 02.2023
- Reviewed hospital charges and insurance claims to ensure accuracy and compliance with medical records, service authorizations, and financial risk guidelines.
- Identified financial clearance issues by tracing claim rejections and denial patterns through the EDI system, supporting resolution efforts.
- Corrected billing issues and submitted appeals to resolve payment disputes, facilitating timely reimbursement for services rendered.
Prescription Typist
Leiter's Compounding
San Jose, CA
09.2008 - 06.2015
- Facilitated high-volume intake documentation and data entry for new and refill prescription orders, ensuring timely processing.
- Entered patient information into pharmacy records and order systems.
- Verified spelling, dosage details, and client notes before final typing.
- Prepared prescription documents for compounding staff and pharmacist review.
- Produced accurate compounding prescription labels for Leiter's Compounding, enhancing workflow efficiency.
- Protected patient PHI in alignment with health system compliance regulations.
- Responded to incoming requests from patients and healthcare providers promptly. and routed messages to pharmacy team members.
- Supported Leiter's Compounding workflow by organizing daily typing assignments.
Skills
- Care Coordination & Navigation
- Referral Tracking & Processing
- Prior Authorization & Pre-Certification
- Insurance Verification (HMO, PPO, Medi-Cal, Medicare)
- Electronic Health Records (Epic, Cerner, athenalDX)
- Denial Management & Appeals
- Patient & Provider Liaison
- Bilingual Medical Communication (English/Spanish)
- EHR & Medical Systems: Epic, Cerner EHR, athenalDX, Cognizant FACETS, Availity, DDE, EDI, ComputerRX
- Financial & Business Tools: QuickBooks, Microsoft Office Suite (Advanced Word, Excel, Outlook)
- Clinical Concepts: CPT/HCPCS Codes, ICD-10-CM Coding, Medical Terminology, Workers' Comp Claim Tracking
Certification
- Certified Billing and Coding Specialist (CBCS) / Certified Professional Coder (CPC) – In Progress
- Certified Revenue Cycle Representative (CRCR) - Healthcare Financial Management Association (HFMA), 2026
- Certified Specialist Accounting and Finance (CSAF) - Healthcare Financial Management Association (HFMA), 2026
- Certificate in Medical Insurance Billing - Cosumnes River College, 2018
Timeline
Principal Access Representative
UC Davis Health (Financial Clearance Unit)
01.2026 - 06.2026
Medical Office Representative 2
Dignity Health Medical Foundation (Urgent Care)
02.2023 - 12.2025
Claims Processor
Blue Cross Blue Shield of Michigan
12.2018 - 02.2023
Prescription Typist
Leiter's Compounding
09.2008 - 06.2015