Nidia Rivera
Revenue Cycle Analyst
Bryant & Stratton College
|
Society of Human Resources Managers (SHRM) 2019
SHRM-CP
EDUCATION:
Bryant & Stratton College Fall 2021
Associate of Applied Science in Human Resources
Cal State Fullerton 2018-2019
Human Resources Management Certification
Society of Human Resources Managers (SHRM) 2019
SHRM-CP
MDxHealth, Inc. Irvine, CA 2019-Present
Revenue Cycle Management Analyst
Responsible for revenue cycle periodic and ad HOC reporting and analysis requests related to system revenue cycle functions. XIFIN Application file maintenance, procedure codes rate changes. Responsible for updating Fee Schedule rate for Laboratory CPT codes and pricing. Generate adjustments, denial and reason codes for revenue payment posting. Work closely with Revenue Cycle Management team generating reports to assist with insurance payment recoupment.
US Direct, Irvine, CA 2017-2019
Human Resources & Payroll Manager
Oversee all aspects of human resources administration, payroll, employee onboarding, benefits, performance management, compliance, and terminations for 100+ employees. Advisor on HR and employee development issues to senior level management. Managed two direct reports. Reported to CEO. Maintained all employee records and human resources records by recording new hires,transfers, terminations, changes in job classifications, merit increases, tracking vacation, sickrequests. Payroll processing/ liaison; distributing checks; maintainingrecords.
Keenan and Associates,Riverside, CA 2013-2017
Provider Relations CSR Lead
Focused on all provider inquiries via phone call/e-mail communications regarding payment status, short pay disputes, escalated resolution inquiries from providers/clients; processed appeals/SBR requests and met effective rules regulations. Assisted Supervisor/Management by providing technical support to processing staff by fully understanding Worker’s Compensation jurisdictional regulations and Fee Schedule interpretations. Knowledge of medical payment posting, medical billing, CPT codes, HCPC, ICD-10.
Corvel Corporation,Ontario,CA 2012-2013
Bill Review Analyst
Bill Review Specialist included extensive knowledge of bill review. Review of medical claims for proper claim adjudication for all provider specialty.
FairIsaac Corporation,Irvine,CA 1996-2013
Product Support Engineer/Fee Schedule Analyst
Required to assist with the clients and branch operations projects related to medical claims review application of Fee Schedule, U&C and PPO guidelines. Provided technical support to processing staff and management by fully understanding Worker’s Compensation Fee Schedule for all states. Provided technical support and outgoing training to clients and processing staff with the Smart Advisor, Comp Advisor and Auto Advisor applications. Accurately identified, prioritized, communicated, and resolved Fee Schedule/PPO issues for multiple product offerings
My personal goals are to be able to retire early so that I can enjoy my family. I want to travel to many countries and know as much people as I can.
My professional goal is to be able to get a job in the Human Resources field so that I can finally enjoy the career that I have been wanting to work on for a long time.
SKILLS:
Problem Solving
Critical Thinking
Excellent Written & Communication Skills
Teamwork
Data Analysis
Project Management
Proficient in Microsoft Office
English/Spanish
I have a certification in Human Resources Management from Cal State Fullerton
My Name is Nidia Rivera, I just turned 54 years old on April 12th 2021. I have three kids; 32, 30 and 23 years old. Also, I have two grandkids a boy (6) and a girl (4). I am the oldest of 6 sibligs, currently working a full time job as a Revenue Cycle Analyst and attending online classes to get my Associates degree in Human Resources Management. In my free time I enjoyed relaxing in my back yard, listening to audio books, taking weekend trips with my husband or just laying in bed watching a good movie with my french bulldog.
210417075009_Week_7.5_Oral_Presentation_Assignment.pptx (.5_Oral_Presentation_Assignment) 6.53mb 210417074859_Laguna_Productions_Inc_Week_5_BUSS213.pptx (.pptx) 16.13mb NIDIA RIVERA
1697 Flanagan St, Pomona, CA 91766 nidiarivera1313@gmail.com
Cell: 909.210.4332
Objective: To secure a challenging Human Resources position that allows me to apply my knowledge and skills, including those related to team management, employee on-boarding, problem-solving and oral and written communication. Strong background in Worker’s Compensation Claims administration with excellent deadline record. Adaptable and transformational leader with an ability to work independently, creating effective opportunities that further establish organizational goals.
PROFESSIONAL EXPERIENCE:
Claremont Graduate University 2021-Present
Human Resources Generalist
Oversee all aspects of human resources administration, payroll, employee onboarding, benefits, performance management, compliance, and terminations for 100+ employees. Advisor on HR and employee development issues to senior level management. Managed two direct reports. Reported to CEO. Maintained all employee records and human resources records by recording new hires,transfers, terminations, changes in job classifications, merit increases, tracking vacation, sickrequests. Payroll processing/ liaison; distributing checks; maintainingrecords.
MDxHealth, Inc. Irvine, CA 2019-2021
Revenue Cycle Management Analyst
Responsible for revenue cycle periodic and ad HOC reporting and analysis requests related to system revenue cycle functions. XIFIN Application file maintenance, procedure codes rate changes. Responsible for updating Fee Schedule rate for Laboratory CPT codes and pricing. Generate adjustments, denial and reason codes for revenue payment posting. Work closely with Revenue Cycle Management team generating reports to assist with insurance payment recoupment.
US Direct, Irvine, CA 2015-2019
Human Resources & Payroll Manager
Oversee all aspects of human resources administration, payroll, employee onboarding, benefits, performance management, compliance, and terminations for 100+ employees. Advisor on HR and employee development issues to senior level management. Managed two direct reports. Reported to CEO. Maintained all employee records and human resources records by recording new hires,transfers, terminations, changes in job classifications, merit increases, tracking vacation, sickrequests. Payroll processing/ liaison; distributing checks; maintainingrecords.
Keenan and Associates,Riverside, CA 2013-2015
Provider Relations CSR Lead
Focused on all provider inquiries via phone call/e-mail communications regarding payment status, short pay disputes, escalated resolution inquiries from providers/clients; processed appeals/SBR requests and met effective rules regulations. Assisted Supervisor/Management by providing technical support to processing staff by fully understanding Worker’s Compensation jurisdictional regulations and Fee Schedule interpretations. Knowledge of medical payment posting, medical billing, CPT codes, HCPC, ICD-10.
Corvel Corporation,Ontario,CA 2012-2013
Bill Review Analyst
Bill Review Specialist included extensive knowledge of bill review. Review of medical claims for proper claim adjudication for all provider specialty.
FairIsaac Corporation,Irvine,CA 1996-2013
Product Support Engineer/Fee Schedule Analyst
US DIREC.
EDUCATION:
Bryant & Stratton College Fall 2021
Associate of Applied Science in Human Resources
Cal State Fullerton 2018-2019
Human Resources Management Certification
Society of Human Resources Managers (SHRM) 2019
SHRM-CP
SKILLS:
Problem Solving
Critical Thinking
Excellent Written & Communication Skills
Teamwork
Data Analysis
Project Management
Proficient in Microsoft Office
Workday & Kronos System
SKILLS:
Problem Solving
Critical Thinking
Excellent Written & Communication Skills
Teamwork
Data Analysis
Project Management
Proficient in Microsoft Office
Workday & Kronos System
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