Lillian Rivera

Handle incoming calls promptly and professionally.

Handle complaints in a timely manner, and document member accounts accordingly.

Research and provide effective resolutions to customer inquiries

communicate empathetically and diplomatically with clear, professional articulation.

meet team goals for quality and customer satisfaction daily.

• Provided compassionate assistance to individuals with disabilities, enhancing quality of life through dedicated support.
• Developed and implemented individualized care plans based on client needs and preferences, ensuring tailored support.
• Trained and mentored new direct care staff on best practices in patient engagement and safety protocols.
• Coordinated transportation and scheduling for appointments, promoting independence among clients while managing logistics efficiently.
• Monitored client health status, documenting changes accurately to ensure timely interventions by medical professionals.
• Advocated for clients' rights and needs within the community, building strong relationships with families and service providers.

• Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
• Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
• Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
• Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
• Explained estimated cost for medical treatments and answered patient questions to promote good understanding of proposed services.
• Determined patient financial needs and referred eligible patients to proper county, state or federal agencies to obtain financial assistance.

• Explain financial responsibilities for services received, payment options and collection procedures to patients or parties responsible for payment. Counsel patients regarding insurance benefits and recommend alternative sources of payment and financial assistance when appropriate.
• Initiate process for collecting co-payments due and perform follow up activity to insure maximum collection was achieved
• Contacted insurance carriers or other sources and acted as an advocate for the patient.
• Work with Case Management, Clinical Staff, Medicaid Vendor, and Family Independence Agencies to assist patients in completing assistance program applications and determine eligibility and coverage.
• Perform all other duties and projects as assigned.

• Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
• Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
• Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
• Performed patient scheduling and registration functions to serve as initial contact point for medical office visits.
• Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
• Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
• Explained estimated cost for medical treatments and answered patient questions to promote good understanding of proposed services.
• Followed document protocols to safeguard confidentiality of patient records.

• Responsible for providing intensive case management services for HIV patients.
• Conducted HIV testing and counseling (substance abuse and harm reduction techniques) Performed initial intake interviews & psychosocial assessments; and, implemented service plans Coordinated and maintained community resource networks Compiled monthly statistical reports.

• Responsible for supervision of 14 staff-members and 14 mentally challenged residents.
• Developed and executed behavioral plans and recreational activities Performed staff evaluations, employment interviews, and budget management Conducted quarterly and annual progress reports.