SONIA P. BONILLA

**** ******* ***. *** ****, CA *1406 818-***-**** adwnbr@r.postjobfree.com

Career Objective

Detail-oriented professional with 25 years of experience and a proven knowledge of research, government policy and regulations, and legal codes. Aiming to leverage my skills and enhance my experience at your company.

Professional Experience

BLUE SHIELD OF CALIFORNIA, WOODLAND HILLS, CA

Appeals & Grievances Intermediate, September 2022-December 2022 (Temporary)

Prepare response letters for provider complaints, grievances, and appeals.

Prepare acknowledgement letters for providers, notifying them of receipt of their PDR (provider dispute request) with specific information, such as Date of Service, assigned case number, and received date.

Maintain system updates by processing data entry information, tracking, organizing, and researching information on systems such as DOFR, FACETS, DOCUMENTUM, etc.

Functions include heavy data entry, calls to providers or 3rd party billers, claims research and faxing in mass quantities for specific projects.

Requests may also include specific information to continue or complete monetary dispute reviews, such as, medical records, WOLs, medication administration, nurse and physician’s notes, and any other specific medical coding corrections as needed for our clinical staff to make proper determinations.

KAISER PERMANENTE, LOS ANGELES, CA

Administrative Assistant, June 2022-July 2022 (Temporary)

Primarily managing issues for Interns doing Residency at this location, via the GME* office

(Graduate Medical Education) for the Family Medicine Department

Helped with onboarding of interns

Prepared lecture schedules and locations

Assigned mentors to the interns on their clinical days for evaluations

Set up meals and conference rooms daily for scheduled lectures

Verified speakers for lectures up to 12 months in advance

PRIMEX CLINICAL LABORATORIES, LAKE BALBOA, CA

Data Entry Clerk, February 2022-March 2022 (Temporary)

Reviewed and validated data entry across all data systems to ensure data entry was accurate.

Compiled data and verified insurance information using a combination of systems

Prepared invoices for the Billing department (COVID-19 billing)

CALIFORNIA DIVERSION PROGRAMS, CANOGA PARK, CA

Administrative Assistant/Receptionist, July 2021-February 2022

My duties included, but were not limited to, enrolling new participants in a variety of programs to satisfy court requirements. Constant communication with the participants was necessary as they navigated through the program with a variety of changes. These changes included schedule changes to the day and time they took their courses, scheduling make-up classes, taking payments for classes, composing letters or reports of Progress or Termination for the courts, attorneys, parole officers and social workers.

Re-enrollments for participants that have been terminated or dismissed.

Constant monitoring of emails requiring immediate attention, along with a high call volume.

Daily updating of files and Excel sheets to match rosters submitted by instructors. These rosters can have up to 35 participants in a class and up to 5 classes are in session daily. Preparing and editing EXCEL spreadsheets for daily classes with updated information of current participants.

This facility also serves as a collection location for drug testing of participants from L.A. County D.C.F.S.

Drug testing was a daily duty. Following county and state protocol was mandatory.

LOWE’S, NORTHRIDGE, CA

Internet Sales Associate/Lead/Cashier, May 2020 – July 2021

As an internet sales lead, I was personally assigned to train each one of my team members. I coordinated with my team the activities for the day. I was responsible for assigning daily duties, which included: ensuring merchandise was accurately accounted for, handled, labeled and ready for customer pick-up.

Included in our daily duties is delivering excellent customer service by listening to customers and using our expertise to help customers with project needs and answering questions.

Overall, most of my time is spent interacting with our customers, by phone and in-person, to ensure they receive the best possible shopping and project planning experience.

Beginning March 2021, I was assigned to manage the Self-Check-Out registers. I managed 4 registers at once. I provide general information, warranty information, the use of certain products and of the registers themselves. I covered other registers as well, for breaks, lunches or to reduce long lines. Customer service is an essential quality required to manage any register at a large retail store like Lowe’s.

HEALTH NET, WOODLAND HILLS, CA

Appeals & Grievances Coordinator, December 2019 – March 2020 (Temporary)

As an appeals and grievance coordinator I analyzed and resolved verbal and written claims and authorization appeals from providers as well as members, along with pursuing resolution of formal grievances from members. I analyzed and researched these complaints, grievances, and appeals. In response to these complaints, I prepared response letters for members and providers. I maintained files on individual appeals and grievances. I performed a high quantity of data entry, tracking, organizing, and researching information. This also included calls to provider’s offices, claims research and from time to time, calls to members for clarification of their grievance or appeal.

SOCIAL SECURITY ADMINISTRATION, PANORAMA CITY, CA

Claims Specialist (GS-11), January 2012 – September 2019

As a claims specialist I communicated daily with the public in person, by phone and by mail. I conducted interviews and processed applications for Aged, Disability and Health Insurance programs to determine eligibility. I was responsible for a multitude of workloads that also include various post-entitlement actions. I provided the public with exceptional customer service by also speaking fluently in both English and Spanish. I was able to resolve complex issues by using my knowledge of Social Security policies. I maintained current knowledge of SSA programs, procedures and systems through office training and review of policy and procedural updates. I managed my time and prioritized workloads to balance demands that met customer and agency expectations and goals. I composed letters for congressional members and prepared presentations for new employees and updated other departments on proper procedures and protocol on certain complex issues. I was the lead in my unit and mentored new employees with daily duties and responsibilities.

SOCIAL SECURITY ADMINISTRATION, VAN NUYS, CA

Customer Service Representative (GS-8), February 2003 -January 2012

As a customer service representative, I served the public daily mostly in person, but also by phone, to answer questions, discuss complex issues about overpayments and claims, along with basic duties such as issuing or replacing social security cards and confirming wages posted annually. I conducted interviews with people of diverse types of socio-economic backgrounds in both English and Spanish. Daily visitors to the office ranged between 300-400, and there were only 3-5 customer service representatives serving the public. The high volume of visitors made me highly organized and skilled while multi-tasking, to serve the highest quantity of people with the high- quality service. During this time, I was also the lead in my unit and mentored multiple new employees with daily duties and responsibilities. Additional duties such as a managing projects, composing letters and reports for congressional members, preparing presentations for various departments including training presentations for new employees was also part of my job description when I became the lead in this department.

Education

U.S. GRANT HIGH SCHOOL, VALLEY GLEN, CA 91401

High School Diploma (June 1993)

Skills

Bilingual/Spanish - Business level speaking, reading, and writing

Experience with Microsoft Office (WORD/OUTLOOK/EXCEL)

Excellent Customer Service/Problem solving

Procedures Development

Conflict Resolution

Mentor/Trainer

Multi-tasker, highly motivated

Excellent organizational and analytical skills

Strong communication skills

Detail and accuracy oriented

Credentials and Licenses

Claims Specialist

Customer Service

Leadership Principles

Transformation Leadership

References:

1.Jesse Casique, Medical Records Custodian @ LA County Department of Mental Health

818-***-**** - Friend

2.Diane Abato, Technical Expert @ Social Security Administration

818-***-**** -Co-worker/Trainer/Friend

3.Maria Polio, Claims Specialist @ Social Security Administration

818-***-**** -Co-worker/Trainee/Friend

Contact this candidate