Anayanci Lopez
Plan Benefit System Analyst
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About
Healthcare revenue cycle and accounting professional with experience in claims processing, benefit configuration support, accounts receivable, billing, reconciliations, payer correspondence, and administrative operations. Skilled at resolving claim exceptions, identifying provider and system setup issues, supporting audits, communicating with internal teams and payers, and maintaining accurate documentation while protecting confidential information. Bilingual in English and Spanish with strong organization, customer service, and multi-system navigation skills.
Experience
Plan Benefit System Analyst - Curative - Austin, TX
(2024-08 - 2026-07)
- Supported day-to-day operations for the System Configuration Team, ensuring tasks were completed, communicated, and tracked across team members.
- Reviewed pended claims and claim exception queues in HealthRules Payer and VBA to resolve provider and payer setup issues and support timely adjudication.
- Processed EFT enrollments, W-9 name and address updates, single case agreements, claim repricing, and contract setup or updates in Merlin.
- Analyzed, tracked, and trended provider, system setup, and claim errors to help identify root causes and support process improvements.
- Assisted with benefit configuration audits, Medicare locality compliance tasks, and professional and facility claim processing requirements.
- Collaborated with IT, Medical Services, and System Support teams to resolve issues efficiently in a fast-paced environment while documenting actions accurately.
- Maintained compliance with HIPAA and internal confidentiality requirements when handling protected information.
Revenue Cycle Specialist - Curative - Monrovia, CA
(2022-03 - 2024-08)
- Managed payer correspondence, aged accounts receivable, insurance follow-up, medical record requests, letters of agreement, refunds, and monthly insurance deposit reconciliation.
- Resolved payer rejections and denials through appeal workflows, helping support accurate and complete claim reimbursement.
- Communicated payment and denial trends to revenue leadership and followed up with insurance companies to determine next steps for outstanding claims.
- Provided patient customer service through phone and email communications and prepared correspondence including claim forms, appeals, and notifications.
- Sorted and processed Revenue Cycle mail, maintained accurate documentation across systems, and complied with HIPAA and confidentiality requirements.
- Worked claim exception queues in VBA to resolve provider and payer adds needed for claim adjudication.
Accounts Receivable Specialist - Monarch Management Content - Arcadia, CA
(2016-10 - 2022-03)
- Prepared monthly billing by gathering information from TRPB and CHRIMS, creating invoices in Great Plains, and sending invoices to tracks.
- Prepared deposit worksheets for cash receipts, including checks and wires related to separate pools and monthly billing.
- Updated Latin America worksheets and Suaposta records for cash receipts, distributions, settlements, and related reconciliations to the general ledger.
- Issued payments and receipts to tracks for Latin America settlements and maintained filing for separate pool settlements and AP checks.
- Performed collections and monthly AR reviews, supported month-end journal entry backup, and processed intercompany adjustments for settlements and deposits.
Accounts Receivable Administrator - Total Education Solutions - South Pasadena, CA
(2007-11 - 2016-09)
- Maintained billing systems, processed invoices, completed collection and reporting activities by deadline, and communicated with customers regarding collection status.
- Supported the Assistant Controller and Controller with fiscal matters, documentation, and administrative accounting tasks.
Education
Liberal Studies coursework - Liberal Studies - California State University, Long Beach (1994-09 - 1997-05)
