Natividad Bonilla

Worked productively in fast-moving work environment to process large volumes of claims. Developed strong relationships with clients, facilitating trust and open communication during the claims process. Enhanced claim processing efficiency by streamlining workflows and implementing best practices. Collaborated with cross-functional teams to expedite complex claims investigations and resolutions. Minimized financial losses by identifying fraudulent claims thorough analysis and investigation. Responsible for accurate billing of services rendered, timely and accurate
collection of expected reimbursement. Once the payer has satisfied the expected reimbursement any patient responsibility balance is billed to the patient. Review of Initial claims to ensure clean claim submission
Review and follow up on billed claims to investigate reason for payment delays or denials by contacting the payer or researching the payer website. Calling payers to verify receipt of claims, what is needed to resolve unpaid accounts, short paid claims and/or other complex denials. Take incoming calls from Insurance payer to resolve any questions regarding claim status and what is being requested to resolve claim for payment. Clear documentation of all work activity in the Ms4 account to ensure continuity throughout
the entire revenue cycle. Using Cerner for medical records and patient information. Using efax and payer portal for medical records request and correspondence request. Developed in-depth understanding of insurance policies and procedures.

Performs follow up activities on all accounts to ensure prompt payment. Maintains daily queue on desktop. Identifies and corrects any coding or billing problems from EOBs. Monitors insurance claims by running appropriate reports and contacting insurance companies to resolve claims that are not paid in a timely manner. Prepares accounts for rebilling and for filing secondary insurance; sends to carrier with necessary documents, as needed. Completes filing and follow-up on insurance denials with coder and physicians to obtain reimbursement. Handles patient and insurance inquiries. Updates the patient account record to identify actions taken on the account. Update correction information and re-files claims, as required. Upload medical records from Cerner. Using eFax to send requested information to the appropriate payer, also using payer portal to send requested medical records, upload appeals and reconsiderations requests. Completes daily and weekly reporting to management. Responsible for achieving and maintaining accounts receivable days. Increased accuracy in claims assessment through meticulous record-keeping and organized documentation. Collected information about rejected claims and developed effective solutions. Identified fraudulent claims through careful analysis of data, protecting company assets from potential losses.

Duties include extensive collection and appeals with insurance filing liens with attorney as well as the courts and workers compensation board of appeals not limited to the State of California, interacted with consumer as well as management assuring that the accounts meet the best standard of attention in order to obtain payment in timely manner, extensive collection for air ambulance as well as ground ambulance service. Billing commercial claims HMO as well as government claims, skip searching, creating liens for several states, interactions with different hospitals in several geographical areas in the country. Negotiate settlement with attorneys, consumers and insurances while meeting the standard incorporated by our client. FDCPA compliance as well as HIPPA. Using a predictive dialer to achieve passing quality review scores on daily calls. Referring calls/accounts to appropriate parties based on customer inquiries. Identify problem accounts and escalate as appropriate. Update the patient account record to identify actions taken on the account. Provide excellent customer service. Achieve passing quality review scores per unit requirements. Produce acceptable unit collection volumes.

Medical Billing for non-emergency / emergency ground ambulance, supply charges, Data entry for new patients, health insurance verification related to all types of insurance as well as government plans ICD 9 coding knowledge of ICD10 presently, Extensive knowledge of Medical policies & procedures, including TAR request, Appeals as well as VA billing .Collections of patients co-payments & co-insurance & deductible, assisted in all types of payment resolution, miles verification as well as the contracted rates for different insurance, obtaining authorization in a timely manner
Extensive interaction with the receiving hospitals in order to obtain updated information as well with the patients. Assuring that all claims' payments & patient information was input in a timely manner.