DELORES BERNAL
FRESNO,CA
Summary
- Proven track record in enhancing operational efficiency at Fresno County Department of Behavioral Health through expert data entry and interviewing skills.
- Excelled in multi-tasking to meet critical deadlines, significantly improving client data accuracy and billing processes.
- Demonstrates exceptional communication abilities, adept at navigating complex healthcare regulations.
- Organized and dependable candidate successful at managing multiple priorities.
- Willingness to take on added responsibilities to meet team goals.
Overview
13
13
years of professional experience
Work History
ADMITTING INTERVIEWER -CHILDREN'S DEPARTMENT
FRESNO COUNTY DEPARTMENT OF BEHAVIORAL HEALTH
07.2023 - Current
- Interview or call parents, guardians, caregiver's to determine eligibility for future appointments.
- Create new charts and complete to ensure proper billing
- Clear financial responsibility
- Mailbox duties, distribute assignments.
- Schedule clearing reports weekly and to complete in a timely manner
- Performs assignments requiring minimal supervision and review.
- Adheres to policies and procedures related to records, privacy regulations and health care reform.
- QA reports-run from DASHBOARD from SmartCare. Format and run on EXCEL
ADMITTING INTERVIEWER-PATHWAYS-MANAGED CARE
Fresno County Department Of Behavioral Health
12.2016 - Current
- Interview clients and determine financial responsibility for cost of medical care, completed appropriate forms to ensure proper billing.
- Learn SAIS, check referrals for clients from Probation, CPS and Calworks.
- Check Lab work eligibility
- Correct monthly progress reports, correct payer strings and AID codes.
- Contact eligibility workers for clients regarding cancelled Medi-Cal benefits.
- Was also Lead over QA reports for the CAAT team (12 reports) to determine the errors, work on backlog, delegate work and train new OA hires for our team.
- Contact staff and contracted providers to give them steps and procedures oh how to do SCARFS, to enter information for a new client and not to create a duplicate client ID.
- Trained in-house supervisor to take over QA reports for his department. To utilize the SAIS system for the Pathways program and provide feedback on Managed CAre tasks for establishing SMART goals benchmarks.
- Updating client information, guarantor codes, check for valid Treatment Plans and edit service information.
- Helped out the Business office with remittance posting, UR Adjustments and corrections
- Worked with Medical Records with duplicate Client ID's and SSN's.
- Worked on procedures for the QA reports and How To instructions.
ADMITTING INTERVIEWER-METRO
FRESNO County Department Of Behavioral Health
08.2015 - Current
- Interview clients and determine financial responsibility for cost of medical care, complete appropriate forms to ensure proper billing.
- Contact private insurance for breakdown of benefits, respond to questions in person, in writing or by telephone.
- Prepare and process reports and correct errors in QA reports.
- Update insurance registration and account information in AVATAR.
- Schedule Clearing report and mailbox duty
- Respond to questions in person, by telephone or in writing regarding health services
- Perform duties with minimal supervision.
- Adheres to policies and procedures related to records, privacy regulations and health care reform.
ADMITTING INTERVIEWER-SUD
Fresno County Department Of Behavioral Health
04.2022 - 07.2023
- QA reports for billing on SUD
- Ran reports and formatted them on Excel
- Eligibility reports from contracted providers to correct guarantor codes and Medi-Cal, private insurance, minor consent.
- Answered emails sent to our mailbox.
- Updated and corrected client charts
- For three months after SUD Admitting Interviewers left for other departments. I did all reports, mailbox duties and client charts on my own.
OFFICE ASSISTANT 1
FRESNO COUNTY DEPARTMENT OF BEHAVIORAL HEALTH
01.2014 - 08.2015
- Investigative billing
- Helping staff with AVATAR for billing corrections, emailing and walking staff through AVATAR to submit SCARFs.
- Running reports and correcting the errors
- Making sure they are all done in a timely manner.
- Working with other team members and communicating problems
- Filling orders for Office Max
- Fill-in for receptionist at the Youth Link Front Desk
- Trained on projects for the Accounting department which consisted of correcting errors on reports, dealing with adjustment codes, accounts payable/receivables and guarantor codes.
- Trained two OA's on my tasks when I changed position to Admitting Interviewer
Cashier/Customer Service
Sears
07.2011 - 02.2014
- Greeted customers entering store and responded promptly to customer needs.
- Welcomed customers and helped determine their needs.
- Worked flexible schedule and extra shifts to meet business needs.
- Operated cash register for cash, check, and credit card transactions with excellent accuracy levels.
- Handling customer complaints
- Ordering merchandise online for customers
- Training new hires for the holidays
- Helped out with cleaning the store on my shifts
Receptionist/Office Cleark
Terri McCracken Attorney At Law
09.2012 - 07.2013
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
- Confirmed appointments, communicated with clients, and updated client records.
- Answered phone promptly and directed incoming calls to correct offices.
- Prepare court documents and client files
Education
No Degree -
Fresno City College
Fresno, CAHigh School Diploma -
Roosevelt High School
Fresno, CA06.1977
Skills
- Data Entry
- Typing
- Interviewing Clients
- Telephone Etiquette
- Data Collection
- Operate a computer in the completion of assignments
- Effectively multi-task to meet challenging deadlines
- Apply laws, rules and regulations governing health care coverage including Medi-Cal, Medicare, private insurance/
- Communicate effectively, both orally and in writing, with people of various educational, socio-economic and cultural backgrounds
Timeline
ADMITTING INTERVIEWER -CHILDREN'S DEPARTMENT
FRESNO COUNTY DEPARTMENT OF BEHAVIORAL HEALTH
07.2023 - Current
ADMITTING INTERVIEWER-SUD
Fresno County Department Of Behavioral Health
04.2022 - 07.2023
ADMITTING INTERVIEWER-PATHWAYS-MANAGED CARE
Fresno County Department Of Behavioral Health
12.2016 - Current
ADMITTING INTERVIEWER-METRO
FRESNO County Department Of Behavioral Health
08.2015 - Current
OFFICE ASSISTANT 1
FRESNO COUNTY DEPARTMENT OF BEHAVIORAL HEALTH
01.2014 - 08.2015
Receptionist/Office Cleark
Terri McCracken Attorney At Law
09.2012 - 07.2013
Cashier/Customer Service
Sears
07.2011 - 02.2014
No Degree -
Fresno City College
High School Diploma -
Roosevelt High School
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