Overview
Work History
Education
Skills
Professional Development
Timeline
Generic

Leidy Bernardez

Overview

6
6
years of professional experience

Work History

Core Operations Associate

ALMA
12.2023 - 12.2024
  • Resolved prior authorization inquiries using Salesforce and other CRM tools.
  • Prepared and submitted insurance appeals with comprehensive documentation.
  • Collaborated with healthcare providers and insurers to facilitate peer-to-peer reviews.
  • Prepared and submitted appeals to insurance companies, compiling medical records, documentation, and justifications
  • Tracked and documented appeal outcomes, following up on unresolved cases for successful resolution

Referral Coordinator

CARECENTRIX
01.2023 - 12.2023
  • Conduct comprehensive intake assessments for patients and healthcare providers gathering critical information to ensure accuracy.
  • Scheduled and confirmed appointments, reducing administrative errors through EHR systems.
  • Maintained HIPAA compliance while addressing patient and provider concerns.
  • Provide ongoing support and guidance to patients and healthcare providers throughout the intake process, addressing their concerns, and answering questions promptly.
  • Usage of ICD and HCPC codes when initiating medical referrals in Epic.

Licensed Benefits Specialist

BLOOM INSURANCE
07.2022 - 01.2023
  • Manage a high-caliber quality of communication, member support, and benefit representation for clients, and follow up on retention leads through outbound communications via phone or in writing.
  • Evaluated patient eligibility and benefits for requested procedures and medications.
  • Collaborated with insurance companies to clarify coverage details and resolve issues related to prior authorization.
  • Maintained files for referral and insurance information, entering referrals into system.
  • Interpreted benefit language to determine covered services under each plan type.

Billing Agent

Synchrony Financial
10.2021 - 07.2022
  • Trained to handle outbound calls and/or receive inbound calls surrounding consumer past due accounts, set up payment arrangements to bring accounts current
  • Classified data by using the correct fields for inputting information into business and customer files, verified data accuracy and completeness by running validation queries
  • Communicated with customers to provide account information, answered mail or telephone inquiries regarding rates, routing and procedures

Patient Representative

Texas Health Resources
Dallas, USA
10.2020 - 10.2021
  • Verified and updated patient insurance details in Epic EHR.
  • Scheduled patient appointments and ensured adherence to HIPAA protocols.
  • Researched and replied to insurance, patient and internal customer inquiries, Maintained and updated information on insurance coverage of diagnosis, procedures and fees
  • Kept smooth patient flow by processing admissions and discharge documents, and securing patient information according to HIPAA protocols by following strict procedures
  • Identified patients needing referrals and obtained prior authorizations, Verified and input patient insurance information into the internal system

Unit Secretary

Montefiore Medical Center
New York, USA
10.2019 - 10.2020
  • Offered skilled support to licensed nursing professionals and office practitioners, promoting smooth appointment flow, Coordinated referrals, setting up appointments and organizing related records
  • Facilitated smooth office communication by receiving, answering and responding to telephone calls., distributing mail and messages, organizing paperwork and coordinating records transfers
  • Scheduled patient appointments in the EMR system
  • Updated patient medical records with direct intake information and transcribed practitioner messages
  • Coordinated patient admissions through proactive communication with hospital personnel

Customer Service Lead

Marshalls
New York, USA
06.2019 - 10.2019
  • Improved team results by coaching and Training team members in correct procedures and successful customer service strategies
  • Managed customer expectations by communicating accurate timeframes and checking on progress, Investigating and resolving invoice and payment issues for customers
  • Avoided revenue losses with diligent attention to customers needs and complaints, helped improve processes and products by relaying customer feedback and successful handling of escalated complaints
  • Reported customer service performance metrics and other KPIs to senior management and suggested improvement strategies
  • Coordinated daily department workflow to maximize customer service team productivity

Education

BS - Health Information Management

Southern New Hampshire University
10.2026

Diploma -

Richard R Green High School
06.2015

Skills

  • Patient Intake and Scheduling
  • Electronic Health Record (EHR) Management (Epic, Kareo, Athenahealth EMR)
  • Zendesk CRM
  • Google Workspace
  • Insurance Verification and Appeals
  • Medical Coding (ICD, HCPC)
  • HIPAA Compliance
  • Strong Written and Verbal Communication
  • Knowledge of HIPAA Regulations

Professional Development

Phipps Neighborhoods Inc., Career Network: Healthcare Program, Participated in an intensive professional skills development program in collaboration with Montefiore Medical Center and Hostos Community College that assists in securing entry-level healthcare employment. Course work included: Anatomy & Physiology, Communication & Interpersonal Skills, Customer Service, and Policy Management, Medical Terminology, Introduction to Healthcare Careers, ICD coding and HIPAA Training. 

Timeline

Core Operations Associate

ALMA
12.2023 - 12.2024

Referral Coordinator

CARECENTRIX
01.2023 - 12.2023

Licensed Benefits Specialist

BLOOM INSURANCE
07.2022 - 01.2023

Billing Agent

Synchrony Financial
10.2021 - 07.2022

Patient Representative

Texas Health Resources
10.2020 - 10.2021

Unit Secretary

Montefiore Medical Center
10.2019 - 10.2020

Customer Service Lead

Marshalls
06.2019 - 10.2019

BS - Health Information Management

Southern New Hampshire University

Diploma -

Richard R Green High School

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