Summary
Overview
Work History
Education
Skills
Timeline
Generic

Dava Rosales

Selma,CA

Summary

Dynamic billing professional with extensive experience at Clinica Sierra Vista, excelling in claims processing and insurance verification. Proven expertise in Epic systems, complemented by strong training abilities. Adept at reconciling accounts and enhancing operational efficiency, ensuring accurate and timely billing for Medi-Cal and Medicare claims.

Overview

16
16
years of professional experience

Work History

Billing Clerk

Clinica Sierra Vista
Fresno, CA
02.2015 - Current
  • Worked on Claims build for Epic direct
  • Worked with User Provision on security and entering provider information
  • Date Courier
  • Utilized NextGen and Epic
  • Verified patient demographic information and insurance information to bill out claims
  • Submit electronic and paper claims for institutional and professional claims
  • Answer patient phone calls and helped them with their questions
  • Corrected claims and resubmissions
  • Received hospital paper batches for charge entry
  • Verified insurance and charges for hospital charges
  • Entered hospital charges and billed out claims
  • Worked follow up claims
  • Worked the Epic system charge review, payer rejection, retroadjudication
  • handled overpayments and requested refund request
  • Train new hires

Billing Specialist/Assistant Office Manager

Family Care Providers of Arizona
Fresno, CA
04.2012 - 02.2015
  • Utilized Misys, Epic and Payorpath software
  • Verify daily deposits
  • Post Medi-cal, Medicare and commercial insurance payments manually and electronically
  • Post patient payments
  • Charge entry
  • Reconcile claims for resubmission
  • Process secondary claim submissions
  • Reconcile patient accounts
  • Received patient calls and interoffice calls
  • Trained new hires
  • Use of multiphone line

Medical Biller/CHDP Coordinator

Valley Family Health Center
Riverdale, CA
06.2009 - 03.2012
  • Utilized Medisoft software
  • Review encounter forms and deposit reports
  • Audit encounter forms and demographics
  • Sent audits to clinics requesting missing or additional information
  • Charge entry for Medi-Cal, Medicare and commercial insurance
  • Process secondary submissions
  • Posted Medi-cal payments
  • Reveiw and processed PM160's for CHDP program
  • Reconcile accounts and processed patient statements

Education

Certificate in Medical Insurance Billing And Coding - Medical Billing And Coding

Heald College
Fresno, CA
04-2008

Associate of Arts - General Studies

Reedley Community College
Reedley, CA
05-2001

Skills

  • Epic certificate in Resolute Billing
  • Epic certificate in Claims
  • Epic certificate in Charge Router
  • Data Courier and Engine Benefits badge
  • Claims processing
  • Insurance verification

Timeline

Billing Clerk

Clinica Sierra Vista
02.2015 - Current

Billing Specialist/Assistant Office Manager

Family Care Providers of Arizona
04.2012 - 02.2015

Medical Biller/CHDP Coordinator

Valley Family Health Center
06.2009 - 03.2012

Certificate in Medical Insurance Billing And Coding - Medical Billing And Coding

Heald College

Associate of Arts - General Studies

Reedley Community College

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