Sandra Rivas
Summary
Detail-oriented Medical Insurance Biller with strong ICD-10 knowledge and proficiency in claims processing. Committed to ensuring accurate claim submissions and resolving billing discrepancies efficiently.
Overview
24
24
years of professional experience
Work History
RCM Medical Billing Coordinator
Veradigm
Raleigh
05.2013 - 11.2025
- Processed medical insurance claims efficiently using Veradigm's Allscripts software.
- Managed demographic charge and payments through import or manual posting for clients.
- Accurately posted payment adjustments and denials from EOBs and ERAs to patient accounts.
- Identified, located, and retrieved remittances from various payer online portals to ensure daily transaction balance.
- Checked claims coding for accuracy according to ICD-10 standards and applicable modifiers.
- Conducted spot audits on charge and payment batches completed by offshore vendors.
- Trained new staff on billing practices and software functionalities.
- Investigated and responded to provider inquiries regarding claim status, payments, and denials to facilitate resolutions.
Medical Biller and Account Specialist
CHMB
Escondido
10.2008 - 05.2013
- Verified patient information and insurance details for accuracy and compliance.
- Processed charge entries and data entries efficiently to maintain accurate records.
- Posted payments from insurance providers and patients accurately.
- Conducted telephone collections from insurance companies and patients to recover outstanding balances.
- Reviewed EOBs and CPT codes to ensure proper billing procedures were followed.
Medical Biller and Collector
Memorial Orthopaedic Surgical Group
Long Beach
09.2007 - 09.2008
- Processed claims appeals to facilitate timely resolutions.
- Conducted insurance verifications to confirm coverage details.
- Completed aging reports to identify outstanding receivables.
- Performed data entry tasks to maintain accurate records.
- Posted payments accurately to reflect transactions.
- Managed electronic billing processes for efficient revenue collection.
- Executed telephone collections from patients and insurance providers.
Medical Biller and Coder
Wilshire Orthopaedic Associates Inc
Los Angeles
04.2002 - 09.2007
- Verified insurance eligibility and benefits for accuracy in claims processing.
- Processed medical billing, focusing on workers' compensation and med-legal claims.
- Collected payments from insurance providers and patients efficiently.
- Reviewed Explanation of Benefits (EOB) statements to ensure correct reimbursements.
- Entered data accurately to maintain comprehensive records.
- Posted payments promptly to update financial records.
- Edited med-legal reports for clarity and compliance.
- Distributed mail systematically to ensure timely communication.
Education
Medical Billing And Terminology
Bryman College
Los Angeles, CA01-2007
High School Diploma -
Manual Arts
Los Angeles, CA06-1999
Skills
- Insurance collections
- CMS-1500 billing forms
- Claim submission efficiency
- Insurance appeals handling
- Payment posting and reconciliation
- Charge Entry
- Data entry accuracy
- ICD-10 knowledge
- CPT coding and modifiers
- Commercial Insurance, Medicare and Medicaid expertise
- Experience with clearing houses and payer healthcare portals
- Medical terminology understanding
- HIPAA compliance awareness
- Denial resolution skills
- Problem-solving abilities
Languages
English
Professional
Spanish
Professional
Timeline
RCM Medical Billing Coordinator
Veradigm
05.2013 - 11.2025
Medical Biller and Account Specialist
CHMB
10.2008 - 05.2013
Medical Biller and Collector
Memorial Orthopaedic Surgical Group
09.2007 - 09.2008
Medical Biller and Coder
Wilshire Orthopaedic Associates Inc
04.2002 - 09.2007
Medical Billing And Terminology
Bryman College
High School Diploma -
Manual Arts