Ivette Lopez

Experience

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  Empresas Fonalledas, Inc

  Jan 2003 - Nov 2005

  Internal Auditor

  Created the Internal Audit Department's Standard Operating Procedures, Charter and Code of Ethics. Developed the annual audit plan according to potential high risk operations or departments. Documentation included narratives, graphs and flowcharts. In charge of performing operational audits and internal control assessments for the Company and its subsidiaries. Also, performed monitoring and assurance engagements for procedures such as purchases, revenues and A/R functions, among others. Responsible for the preparation of audit reports including findings and recommendations for each engagement.Participated in meetings and presentations to Executive Management. Assessed the implementation of corrective actions through follow-up procedures.Liaison between external auditors and the company. In charge of coordinating all external audits related to contract compliance. Mostrar menos

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  MC-21 LLC

  Jan 2003 - Jan 2010

  Compliance and Rebates Administrator

  In charge of rebate billing to pharmaceutical companies, preparing all related financial reports including DIR and other Medicare Part D reporting requirements. Supported IT with the PDE reconciliation. Direct supervision of two accounts receivable accountants and one senior accountant. Participated in the buget development process and assisted other financial functions. Developed policies Ana procedures for the area.Related to compliance duties, in charge of implementing the company's compliance plan, new hire training, compliance monitoring, among other tasks. Mostrar menos

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  Estudios Tecnicos, Inc.

  Nov 2010 - Jul 2016

  Compliance Consultant

  Provide technical assistance related to federal funds and compliance to municipalities and governmental agencies in the areas of health, housing and community development.In charge of process documentation and improvement engagements for government agencies, including the Office of Management and Budget (OGP) and the PR Treasury Department.Participated in several projects related to private industry and not-for-profit organizations.

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  Abarca Health

  Jan 2016 - now

  • Direct the claims reprocessing and adjustments team wich supports retro-LICs, FIR and restacking of accumulators, to ensure accuracy and compliance. • Support Government Programs. Oversee the Encounters Operations team to ensure timely and accurate submissions for the Medicaid BoB.• Partner with the Pharmacy Network Strategy team to assure pharmacy payments are issued appropriately and timely. • Identify opportunities for system enhancements to support client needs and operational efficiency.• In charge of timely submission of regulatory reporting requirements, including DIR.• Participate in strategic and operational committees.• Support special projects, including RFPs and client implementations. Mostrar menos Responsible for managing the Finance Operations team, which is responsible for client billing and reconciliation, pharmacy payments and reporting (EOPs/835s), DMR payments, Encounters, pharmacy price appeals, and claims/payment adjustments. Manage a team of six (6) analysts responsible for the provider payment process and related functions.Oversee the claims reprocessing and adjustments process to ensure accuracy and minimize financial impact. Work closely with the Pharmacy Network Strategy team to assure pharmacy payments are issued appropriately and timely. Identify opportunities for enhancements to the platform financial modules to support client needs and operational efficiency. In charge of timely submission of regulatory reporting requirements, including DIR. Support special projects, including RFPs and client implementations. Mostrar menos

  • Associate Director Claims Services

    May 2022 - now

  • Associate Director Financial Operations

    Sept 2021 - Oct 2022

  • Senior Manager Finance Operations

    Jan 2020 - Sept 2021

  • Finance Operations Manager

    Jan 2016 - Jan 2020