Fred Rivera Email & Phone Number

Menlo Park, California, United States

● Review and correct all billable claims in billing software in accordance withpayor specific guidelines and billing requirements within one working day.● Perform timely and appropriate follow-up to resolve unbillable claims.● Process secondary billing in accordance with department procedures.● Review all high dollar claims for potential stop-loss criteria and directstop-loss claims to correct payor processing unit.● Prepare and submit appropriate billing attachments as required by specificpayors.● Mail paper claims to appropriate payors.● Inform manager of recurring claim errors in order to facilitate systemimprovements.● Understand and comply with all current Medi-Cal regulations.● Follow-up on 50 accounts per day.

Fremont, California, United States

● Followed up on unpaid accounts in patient accounting systems with thepayers on phone or via payer portals● Worked payer denials based on claim process adjudication● Reviewed accounts for possible underpayments; research contracts,guidelines and resolved payment with payer● Processed appeals with payer● Processed bad debt request transfers as applicable● Processed contractual adjustments/write offs● Performed all billing for commercial and government payers● Posted payments from all payers● Reviewed worklist accounts with charge issues and resolved on a timelymanner.● Followed up on unpaid claims● Processed refunds for accounts payable● Reviewed and resolved electronic acknowledgement payerrejections/denials; Rebills claims based on requests from Follow Up repsdue to denials received.

Mountain View, California, United States

• Billed invoices for 3 Certified Prosthetist/Orthotist• Submitted paper and electronic claims to various insurance companies• Followed up on accounts• Checked eligibility and obtained authorizations for HMO claims• Posted insurance payment• Work on the Month End and Quarterly End Closing Duties• Processed appeals• Scheduled patients• Work closely with corporate for monthly revenue numbers• Answer billing inquiries from patients, staff, clients and insurance companies

South San Francisco, California, United States

● Answered billing inquiries from patients, staff, clients, and insurance companies● Researched & followed up on claims to be paid on Blue Cross, Blue Shield &Medicare● Resolved claims that have been denied by various insurances companies● Documented appropriate notes on corresponding systems as needed.● Posted payments● Reviewed payer denials and appeals● Performed charge entry and charge batch balancing● Performed Electronic and hardcopy claims editing and submissions to variouspayers (Government, Managed Care, and Commercial)● Performed accounts receivable collections and payer follow-up● Performed credit balance review and resolutions