Luis Eduardo Riera
Sales & Operations Professional
34747, Kissimmee, Florida.About
Highly driven and results-oriented professional with over 6 years of experience in sales, customer relationship management, and operational efficiency, consistently exceeding aggressive business goals. Possesses specialized expertise in insurance billing, claims appeals, and comprehensive inventory and warehouse management, coupled with strong computer proficiency. Bilingual in Spanish and English, adept at fostering high levels of customer satisfaction and driving growth in dynamic environments.
Work
Orlando, FL, US
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Summary
Drove sales growth and managed client relationships for a beverage distributor, consistently exceeding targets and optimizing product availability.
Highlights
Consistently exceeded sales goals for an assigned territory, achieving strong revenue growth through strategic account management and proactive client engagement.
Expanded client base by acquiring new business and nurturing existing accounts, identifying viable growth opportunities to increase market share.
Managed accounts receivable, ensuring timely invoice payments and improving cash flow efficiency across client portfolios.
Cultivated strong client relationships and ensured a favorable customer experience by maintaining high professionalism during merchandise delivery and addressing client needs.
Optimized client inventory levels through weekly monitoring, ensuring adequate product availability and preventing stockouts across all managed accounts.
Sanford/Miami, FL, US
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Summary
Coordinated comprehensive claims processing and appeals for a pharmacy service, ensuring compliance and maximizing payment recovery.
Highlights
Ensured 100% accurate and timely submission of claims and supporting documentation by conducting thorough reviews of eligibility, proper coding (NDC, HCPC), and authorizations.
Resolved complex insurance payment discrepancies, investigating and acquiring necessary remits to complete the posting process and recover outstanding revenue.
Managed and submitted multi-level appeals (first, second, and third) for denied claims, successfully overturning rejections and securing appropriate payments.
Monitored and analyzed insurance denials and payment trends to identify areas for process improvement in company billing and collection strategies.
Maintained comprehensive and organized records for all paid claims, denied claims, and appeals, ensuring data integrity and audit readiness.
Sanford, FL, US
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Summary
Provided critical administrative and record management support, ensuring efficient office operations and accurate financial and patient documentation.
Highlights
Proficiently operated office equipment and software (word processing, spreadsheets) to prepare accurate reports, invoices, financial statements, and medical records.
Executed essential bookkeeping duties, including managing credits, collections, and financial record-keeping, ensuring accuracy and compliance.
Accurately completed and processed insurance and other claim forms, facilitating timely submissions and patient care continuity.
Conducted patient interviews to gather critical information for intake, case histories, and insurance documentation, maintaining confidentiality.
Maintained organized medical records, technical libraries, and correspondence files, ensuring efficient retrieval and data integrity for operational needs.
Sanford, FL, US
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Summary
Managed comprehensive warehouse and inventory operations for a medical facility, ensuring efficient stock control and adherence to quality standards.
Highlights
Managed the acceptance, processing, packaging, and shipping of incoming medical inventory and orders, maintaining accuracy and adherence to schedules.
Conducted precise verification of lot numbers, expirations, and quantities for all received inventory, upholding rigorous quality control standards.
Systematically accounted for and rotated stock on shelving, minimizing waste by ensuring first-in, first-out (FIFO) principles based on expiration dates.
Performed sterilization and preventative maintenance on returned Durable Medical Equipment (DME) and ambulatory devices, ensuring readiness for reuse and compliance.
Maintained a clean, organized warehouse environment, strictly adhering to sterilization policies for medical packing areas and safely disposing of expired products per pharmacy guidelines.
Education
Languages
Spanish
English
Skills
Sales & Business Development
Sales Goals Attainment, Account Management, New Business Acquisition, Territory Management, Client Engagement, Promotional Event Management, Growth Opportunity Identification.
Customer Relationship Management
Customer Satisfaction, Client Communication, Professionalism, Conflict Resolution.
Operations & Inventory Management
Warehouse Operations, Inventory Control, Stock Rotation (FIFO), Order Processing, Shipping & Receiving, Quality Control, Medical Device Sterilization, Supply Chain Optimization.
Claims & Billing
Insurance Billing, Claims Processing, Appeals Management (1st, 2nd, 3rd levels), HCPC Coding, NDC Codes, Eligibility Verification, Payment Discrepancy Resolution, Accounts Receivable, Compliance.
Administrative Support
Office Management, Record Keeping, Financial Statements, Invoicing, Bookkeeping, Data Entry, Document Management, Microsoft Office Suite (Word, Excel).
References
David Acosta
516-808-2719, 870 Regatta Bay Drive Apt 208 Orange City, FL
Lisbeth Tuner
321-439-2252, 2404 Gallery View Blvd Winter Park, FL