Renee Rivera
Sherman Oaks
Summary
Dedicated and adaptable professional with a proactive attitude and the ability to learn quickly. Strong work ethic and effective communication skills. Eager to contribute to a dynamic team and support organizational goals.
Overview
22
22
years of professional experience
Work History
CSR 2
Anthem Blue Cross/Elevance Health
Woodland Hills
11.2021 - 07.2025
- Uses, protects, and discloses anthem members protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
- Answered a high-volume of inbound calls- answering health insurance benefits/concerns along with providing any additional information on policy's.
- Identified, prioritized, and resolved most questions and concerns independently with high level of customer service skills with FCR.
- Demonstrated excellent verbal communication skills when interacting with customers.
- Utilizes anthem systems to resolve members needs such as authorizations, claims eligibility, benefits, appeals, TARs.Resolved diverse member issues by leveraging Anthem systems, leading to substantial improvements in first-call resolution rates.
Admitting/ ER Registration
Sherman Oaks Hospital
Sherman Oaks
09.2016 - 11.2021
- Executed 1:1 in services to explain insurance verification , collect demographics, authorization requirements and financial responsibilities.
- Strong understanding of HMO's, PPO's, Medicare, POS and Medi-Cal plans, Work. Comp, In Custody, PE Eligibility.
- Collect insurance co-payments, obtain admission authorizations.
- Coordinated insurance verification efforts, achieving a noticeable reduction in claim denials and expediting patient admissions.
P.B.X/Communications
Valley Presbyterian Hospital
Van Nuys
04.2010 - 08.2018
- Be accountable and responsible for operating telecommunications complex call processing software in placing, receiving and relaying calls.
- Arrange for emergency services by coordinating the availability of medical personnel through effective use of telephones and paging system.
- Managed high-volume phone communications with precision and courtesy.
- Ensured swift emergency response by monitoring alarms and executing protocols.
- Protected confidential information following strict guidelines.
- Enhanced safety for patients and staff through reliable alarm monitoring.
- Maintained accurate logs of communications and emergency incidents, supporting compliance with healthcare regulations and enhancing operational transparency.
P.B.X Operator
Providence Tarzana Hospital
Tarzana
02.2005 - 04.2010
- Operated complex telecommunications systems to facilitate seamless communication, enhancing operational efficiency and ensuring prompt emergency response.
- Responded to emergency codes swiftly, implementing systematic protocols that ensured safety and enhanced overall patient care during crises.
- Fostered strong communication links among departments, promoting teamwork and ensuring that all personnel were informed and responsive during emergencies.
- Assisted external callers with department directory information as needed.
- Operated multi-line telephone system to answer incoming calls and direct callers to specific destinations based on their needs.
- Monitored and operated PBX switchboard to route incoming calls to appropriate personnel.
Billing Assistant
Life Alert
Encino
08.2004 - 02.2005
- Monitored collections activity and maintained contact with customers regarding overdue payments.
- Reconciled accounts to ensure accuracy of billing information.
- Managed customer accounts and updated records as needed.
Unit Secretary
Kaiser Permanente
Woodland Hills
12.2003 - 06.2004
- Provided clerical support including filing, faxing, photocopying and data entry of patient information into electronic health record systems.
- Responded to requests from internal staff regarding patient information in accordance with HIPAA regulations.
- Assisted nursing staff with administrative tasks such as scheduling appointments, ordering supplies and preparing charts.
Education
High School Diploma -
Cleveland High School
Reseda, CaliforniaSkills
- Communication
- Time Management
- Results Oriented
- Dedication
- Problem Solving
- Reliability
- Customer Focus
- Patient Care
- Empathy
- Attention to Detail
- Organizational Skills
- Service Orientation
- Fast learner
- Customer service
- HIPAA compliance
- Health insurance knowledge
- Conflict resolution
- Strong communication
- Data entry accuracy
- Attention to detail
- Problem solving
- Call center experience
- Microsoft outlook
- Cultural awareness
Timeline
CSR 2
Anthem Blue Cross/Elevance Health
11.2021 - 07.2025
Admitting/ ER Registration
Sherman Oaks Hospital
09.2016 - 11.2021
P.B.X/Communications
Valley Presbyterian Hospital
04.2010 - 08.2018
P.B.X Operator
Providence Tarzana Hospital
02.2005 - 04.2010
Billing Assistant
Life Alert
08.2004 - 02.2005
Unit Secretary
Kaiser Permanente
12.2003 - 06.2004
High School Diploma -
Cleveland High School
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