Luigi Karlo Bonillo

LUIGI KARLO BONILLO MEDICAL BILLER Experienced medical biller with expertise in claims submission, insurance verification, and resolving billing issues. Proficient in managing denials, appeals, and navigating Medicare, Medicaid, and private insurance processes. Detail-oriented and committed to ensuring accurate, compliant, and efficient billing operations. EXPERIENCE July 2024 - December 2024 Clearsource- Sunrun CUSTOMER CARE REPRESENTATIVE Managed and resolved customer billing inquiries, including discrepancies, payment processing, and account adjustments, ensuring accuracy and transparency. Investigated and resolved complaints related to billing, service performance, and installation issues, achieving a high resolution rate within established service-level agreements (SLAs). Maintained detailed records of customer interactions, complaints, and resolutions in CRM systems to ensure consistency and improve service quality. Provided proactive updates to customers regarding complaint status and escalations, fostering trust and satisfaction. August 2023 - April 2024 Clearsource - EMI Health CUSTOMER CARE REPRESENTATIVE Assisted patients, providers, and other stakeholders by delivering accurate and timely information about benefits, coverage, claims, and eligibility. Investigated denied claims, analyzed billing details, and facilitated corrections or resubmissions to ensure proper reimbursement. Offered detailed information about policy coverage, medical necessity requirements, and provider credentialing processes. Addressed escalated inquiries, resolved discrepancies, and ensured customer satisfaction by liaising with internal departments and external providers. Adhered to HIPAA and healthcare regulations, maintained accurate records of interactions and ensured the confidentiality of sensitive information. Identified opportunities to enhance workflows, reduce claim denials, and improve overall customer experience. April 2023 - September 2023 RSI - Ruby Staffing Inc. MEDICAL BILLER - CLAIMS CREATION Prepared, reviewed, and submitted accurate claims to insurance providers and clearinghouses. Verified claims for completeness, proper coding, and compliance with payer policies. Resolved denied or unpaid claims through effective follow-ups and appeals. Ensured compliance with billing standards by correcting coding errors and verifying medical documentation. Monitored claim submissions to ensure timely processing and reduce rejections. Communicated with insurance companies to address issues related to claim approvals and denials. Maintained detailed records of submitted claims and follow-up activities. Ensured compliance with HIPAA and medical billing regulations. EDUCATION Computer Science- Mapua University High School 2003 -2007 Sacred Heart Acadermy CONTACT --Block 8 Lot 7 David Street North Olympus Novaliches Quezon City LANGUAGE English - C2 EXPERIENCE January 2022 - November 2022 TSI - Transworld Systems Inc. | Accounts Receivable (A/R) Medical Biller MEDICAL | Appeals Specialist BILLER | Payment Posting Medical Biller | Accounts Receivable (A/R) Medical Biller Monitored and managed accounts receivable to ensure timely resolution of outstanding claims. Followed up on unpaid or partially paid claims with insurance companies and patients. Analyzed aging reports to identify and prioritize overdue accounts for collection. Communicated with payers to resolve discrepancies and expedite payments. | Appeals Specialist Investigated denied or underpaid claims to determine the cause and appropriate action. Prepared and submitted detailed appeals with supporting documentation to insurance companies. Tracked appeal outcomes and updated claim statuses in the billing system. Collaborated with providers to ensure accurate coding and compliance for successful appeals. | Payment Posting Medical Biller Accurately posted payments from insurance companies and patients to billing accounts. Reconciled payment discrepancies and resolved issues in coordination with payers. Maintained detailed records of payment allocations, adjustments, and write-offs. Ensured proper application of EOBs and compliance with financial policies. June 2020 - July 2021 Concentrix CUSTOMER CARE PROFESSIONAL Assisted providers and members with claims status, benefits, and coverage inquiries. Resolved claim discrepancies, including denials and underpayments. Explained policy terms, copayments, deductibles, and authorization requirements. Guided claims appeals with accurate documentation and compliance. Verified eligibility and credentials for seamless claims processing. Maintained detailed, HIPAA-compliant records of interactions. September 2017 - February 2019 Optum Global Solutions UBH | Behavioral Health Representative | Claims Specialist | Authorization Specialist | Behavioral Health Representative Assisted patients, providers, and stakeholders with behavioral health benefits, eligibility, and claims inquiries. Coordinated care services by verifying patient coverage for behavioral health programs. Supported patients in accessing mental health and substance use treatment services. Maintained strict confidentiality and adhered to HIPAA guidelines when handling sensitive information. | Claims Specialist Reviewed, analyzed, and processed behavioral health claims for accuracy and compliance. Investigated and resolved denied claims by identifying issues and initiating corrections or appeals. Provided detailed claims status updates to providers and ensured timely reimbursement. Communicated with payers to address discrepancies and expedite claim resolution. | Authorization Specialist Managed pre-authorizations and approvals for behavioral health services, including outpatient therapy, psychiatric evaluations, and testing. Verified medical necessity and ensured compliance with insurance and provider guidelines. Collaborated with providers to obtain required documentation for authorizations. Maintained accurate records of authorizations and communicated updates to providers and patients. June 2015 - January 2017 Concentrix CUSTOMER CARE REPRESENTATIVE Assisted customers with account inquiries, transactions, and billing issues. Resolved discrepancies and processed payments or adjustments accurately. Provided guidance on account features and maintained accurate records. Ensured compliance with financial regulations and company policies. ICD-10 coding CPT coding HCPC coding Claims Adjudication Accounts Receivable HIPAA Compliance Organizational Skills Customer Service Administrative Support Billing EPIC Availity Navinet Citrix Sharepoint ISET Salesforce IDARS