Edwin Bernal
Pico Rivera,CA
Summary
To obtain employment in Medical Billing and Payment/Cash Poster utilizing knowledge or medical terminology, insurance policies and extensive knowledge of how to use CPT and ICD-9 coding techniques. As well using knowledge in retail by using skills to sell and provide customer service.
Overview
12
12
years of professional experience
Work History
Revenue Cycle Payment Posting Specialist
AIDS Healthcare Foundation
04.2021 - 07.2024
- Managing and applying payments both electronically (ERA, EFT), and manually (paper checks).
- Ensure each posted batch is balanced and recorded for daily reconciliation.
- Maintaining a schedule while remaining organized and exercising excellent communication skills, attention to detail, and data input accuracy.
- Researched complex issues utilizing internal and external resources and contacts
- Interpreting and breaking down explanations of benefits/payments by payments, patients' responsibilities, adjustments, and denials.
- Handling credit cards from hospitals and professional accounts is processing them and posting to correct accounts.
- Refunding back to credit cards.
- Posting payments, but not limited to, posting to suspended and/or unidentified accounts.
- Knowledgeable and efficient using payer websites, clearinghouse, and other tools available to validate.
Cash Poster
KPC Health
Santa Ana, CA
11.2018 - 04.2021
- Knowledge of Citrix billing/cash posting software - includes applications of: Paragon, activity posting, cash control, electronic remittance, patient maintenance, transaction maintains, Registration, One Content
- End of day, creating batches to balance posting to daily deposit
- Familiar with websites such as: Medi-Cal, Change HealthCare, Optum Provider login, Humana Tricare, Instamed, Payspan, NaviNet, Availity, etc
- Update spreadsheets and batch balancing sheets on a day to day basis
- Downloads of Treasury Information Report from Wells Fargo, along with Lockbox/Correspondence
- Deposit of checks (Desktop Deposit) using PANINI scanner through Wells Fargo website
- Knowledge of General Ledger (GL) checks and accounts
- Posting manually through paper EOBS and electronic ERA's
- Posting Zero Eobs / Transfer payment between accounts and/or through intercompany
- Responsible of dietary money to hand over to GARDA
- Call insurance companies when needing to request EOBs
- Organize daily work packet
- Responsible for work and back-up to be turned in to accountants/hire ups
- Knowledge of running credit cards/virtual credit cards through Wells Fargo/One Source
Payment Poster
IPC / TeamHealth
North Hollywood, CA
08.2015 - 10.2018
- Processed payments, adjustments, correspondence, and denials
- Performs day-to-day administrative functions and general office duties including but not limited to word processing, and data entry
- Use billing software of TH-IDX - WRQ Reflection for UNIX and Open Vms program / GroupCast/ IDX / GDI
- Knowledge of GPMS software
- Working through GE / IDX to process ERA exchanges in a quicker manner
- Knowledge of Zirmed
- Update spreadsheets and batch balancing sheets on a day to day basis
- Working on paper EOBs and electronic ERA
- Reviewing EOB's and/or ERA's for accurate payment/reimbursement
- Handled all kinds of insurance claims, including private, Medicare / Medicaid and insurance fraud
Data Entry / Claim Follow Up / Collections
Affordable Billing Solution
Pasadena, CA
09.2012 - 02.2015
- Performs day-to-day administrative functions and general office duties including but not limited to word processing, copying, filing, faxing, answering phones and data entry
- Maintain and update records for all aspects of patient billing and management information records
- Verify accuracy on all patient encounter forms submitted for processing or billing
- Enter charges, receipts, changes and other input into the computer
- Keep current on informational changes in billing procedures
- Handled all kinds of insurance claims, including private, Medicare and insurance fraud
- Prepared, keyed in, edited, and proofread health check records
- Making phone calls to insurance companies / 20-30 calls a day min
- Used billing software /EMR/EHR: (ex: Relay Health, office Ally and Best Notes)
- Processed payments, adjustments, correspondence, denials and check tracers towards accounts
- Reviewing EOB's and/or ERA's for accurate payment/reimbursement
- Negotiation of Single Case Agreements and reimbursement for claims submitted to insurance companies for Out of Network providers and assured payment done accurately
Education
High School Diploma -
El Rancho High School
Pico Rivera, CASkills
- Excel
- Word
- PowerPoint
- Outlook
- Computer literacy
- Deposits
- Follow-up skills
- Data entry proficiency
- Payment reconciliation
- Payment posting
- Month-end closing procedures
- Billing systems and software
- Research and due diligence
- Cash handling experience
Timeline
Revenue Cycle Payment Posting Specialist
AIDS Healthcare Foundation
04.2021 - 07.2024
Cash Poster
KPC Health
11.2018 - 04.2021
Payment Poster
IPC / TeamHealth
08.2015 - 10.2018
Data Entry / Claim Follow Up / Collections
Affordable Billing Solution
09.2012 - 02.2015
High School Diploma -
El Rancho High School
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