Summary
Overview
Work History
Education
Skills
Affiliations
Certification
Timeline
AssistantManager
Sandy Rivera

Sandy Rivera

CPC
Groveland,Florida

Summary

Highly skilled and enthusiastic professional with more than 12 years of experience managing operations in patient-centric medical offices. Successfully oversee billing, collections, account receivables, administrative practice functions, and patient services. Develop and lead productive and efficient office staff. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

Overview

13
13
years of professional experience
1
1
Certification
1
1
Language

Work History

Director of Medical Billing and Accounts Receivables, Systems Administrator

Lake Centre for Rehabilitation
Leesburg
01.2014 - 12.2019
  • Led billing team, driving strategies for collecting payments from patients, insurance companies, and government health programs, facilitating the appeals process and reporting collections when required
  • Oversaw and managed the daily performance of the billing department, optimizing accounts receivable operations
  • Determined appropriate and effective performance metrics and staff requirements, maximizing department efficiency and accuracy while providing outstanding customer service
  • Acted as project lead in the implementation of the Raintree billing system, training users, establishing a strategy for user testing and implementation, and providing technical support
  • Detailed upcoming software upgrades and system sprints to team members.
  • Oversaw and developed clinical departments through hiring, training, and evaluating staff.

Billing and Collections Supervisor

North Shore-LIJ Health System
12.2009 - 05.2013
  • Supervised medical billing processes, verifying the accuracy, submitting claims, filing appeals for incorrect payments, maximizing reimbursement
  • Supervised Accounts Receivable and Payment team members, identifying payment patterns and trends for revenue cycle optimization
  • Acted as a liaison between the finance department, billers, coders, and third-party payers, resolving billing and reimbursement inaccuracies
  • Performed month-end closing processes, maintaining accurate documentation and reporting
  • Trained and mentored coding and Accounts Receivable teams, educating them on billing, coding, and payor-specific guidelines for services rendered.

Accounts Receivables Supervisor

The Mentor Network
Plantation, FL
01.2003 - 04.2006

Manage day-to-day Account Receivable operations for 22 locations within the state of Florida and supervised 4 Accounting Coordinators.

Performed month-end closing

Assist Staff Accountant with revenue uploads, cash posting, creating credits and debits

Generate invoices for monthly contract billing and maintained Payer information via Oracle Financials

Ensure payments reconcile with deposit and monthly batch

Maintain strong professional relationships with Program Managers to assist them in submitting proper documentation for prompt payment

Analyze monthly Accounts Receivable aging report for each location to prioritize collection according to DSO

Establishing methods such as periodic audits, to improve the practice's efficiency and quality of services, and to reduce the office's vulnerability to fraud and abuse

Handled large volume of Medicaid, Medicare,managed care plans and patient billing

Researched and corrected re-filed claims weekly to ensure proper payment on previously rejected claims

Maintained adequate communication links between AR, AP, and Clinical Supervisors

Post cash payments and apply refunds, credits, and adjustments to Oracle

Education

Diploma - Medical Coding, and Billing

Integrity Coding School

Certificate, Health Administration - undefined

Concorde Career College

TCI College Certificate, Business Administration - undefined

Lake Sumter State College

Skills

RELEVANT SKILLS and TRAININGundefined

Affiliations

American Academy of Professional Coders (AAPC), Member in good standing Certified Professional Coder (CPC)

Certification

CPC - Certified Professional Coder

Timeline

CPC - Certified Professional Coder

10-2022

Director of Medical Billing and Accounts Receivables, Systems Administrator

Lake Centre for Rehabilitation
01.2014 - 12.2019

Billing and Collections Supervisor

North Shore-LIJ Health System
12.2009 - 05.2013

Accounts Receivables Supervisor

The Mentor Network
01.2003 - 04.2006

Diploma - Medical Coding, and Billing

Integrity Coding School

Certificate, Health Administration - undefined

Concorde Career College

TCI College Certificate, Business Administration - undefined

Lake Sumter State College
Sandy RiveraCPC