Suheily Nevarez Rivera
Summary
Recent BSN graduate passionate about serving veterans and committed to upholding the values of the VA Hospital. Clinical experience includes rotations in acute care, mental health, and geriatrics, demonstrating proficiency in essential nursing skills such as medication administration, patient assessment, and wound care. Possesses strong critical thinking abilities, clear and empathetic communication skills with patients, families, and healthcare teams, and a proven capacity to adapt to changes in healthcare protocols and technologies. Skilled in interdisciplinary collaboration, comfortable with healthcare technologies and electronic documentation systems, and committed to cultural competence in patient care. Known for genuine care and empathy towards patients and their families, with demonstrated leadership potential and a track record of reliability, accountability, and ethical conduct. Eager to contribute to the healthcare needs of our nation's heroes with empathy, dedication, and a commitment to excellence.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Sales Clerk
US Coast Guard Exchance System
03.2007 - Current
- Provided excellent service and attention to Soldiers, veterans and their families when face-to-face or through phone conversations.
- Cash Sales - Handled more than $15,000 a day in cash sales.
- Balanced register and prepared daily sales summary and deposits, customer service work directly with customers, knowledgeable in the latest electronics on the market.
- Great with the Keep It New (extended warranty program) restock shelves, answer phone.
Financial Collection Specialist
MCS Medical Plan
09.2021 - Current
- Reviewed accounts for past due balances and contacted customers to arrange payment plans or collect payments.
- Provided timely and detailed updates on collections activity to management.
- Handled incoming calls from customers regarding account status, billing inquiries, payment arrangements.
- Created letters and emails requesting payment from delinquent customers using approved templates.
Claims Analyst II Ajustmen Clasicare
MCS Medical Plan
12.2019 - 08.2021
- Evaluated pending claims to identify and resolve problems blocking auto-adjudication.
- Inputted data into the system, maintaining accuracy of provider coding information and reported services.
- Based payment or denials of medical claims upon well-established criteria for claims processing.
- Retained strong medical terminology understanding in effort to better comprehend procedures.
Providers Call Center Representative
MCS Medical Plan
07.2016 - 12.2019
- Verify eligibility of patient's medical & dental services
- Medical claims status and appeal process
- Work with CRM case application create & follow up cases regarding claims situations
- IT Assistance with MSC web page.
Call Back - Specialice Service Unit
MCS Medical Plan
05.2015 - 07.2016
- Situations raging in all department's such as: Pharmacy, enrollment, DME, Dental, Finance, Claims and situations with providers
- Also I have specific assignment with Claims USA, Situation with providers
- Work with TTY Service for hearing impaired
- Administrative services: Right fax Tool (fax util).
Customer Service Representative
MCS Medical Plan
03.2014 - 05.2015
- Answerer phone calls so it could be handled according to the protocol established by the unit of quality according to federal laws stipulates by Medicare
- Trained to give backup to the commercial department in all duties.
Education
Local & International Cousine -
Instituto De Banca & Comercio
01.2007
High School Diploma -
Adolfina Irizarry De Puig, High School
01.2006
Bachelor of Science - Nursing
NUC University
Bayamon Skills
- Clinical Competence
- Critical Thinking
- Communication Skills
- Adaptability
- Technological Proficiency
- Teamwork and Collaboration
- Cultural Competence
References
REFERENCES AVAILABLE UPON REQUEST
Languages
Spanish
First Language
English
Proficient (C2)
C2
Accomplishments
- Certificate Award in recognition of 15 years of service in the Government of the United States of America
Certification
Registered Nurse (RN) License, Puerto Rico Board of Nursing
Timeline
Financial Collection Specialist
MCS Medical Plan
09.2021 - Current
Claims Analyst II Ajustmen Clasicare
MCS Medical Plan
12.2019 - 08.2021
Providers Call Center Representative
MCS Medical Plan
07.2016 - 12.2019
Call Back - Specialice Service Unit
MCS Medical Plan
05.2015 - 07.2016
Customer Service Representative
MCS Medical Plan
03.2014 - 05.2015
Sales Clerk
US Coast Guard Exchance System
03.2007 - Current
Local & International Cousine -
Instituto De Banca & Comercio
High School Diploma -
Adolfina Irizarry De Puig, High School
Bachelor of Science - Nursing
NUC University
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