Delia Miranda BSN, RN
Jurupa Valley,Ca
Summary
Patient-focused and ambitious new grad registered nurse with 6+ years of experience in the healthcare field with a passion for learning and growing professionally within a dynamic healthcare environment. Seeking a position to improve the health and well-being of the people, patients, community, and world as an integral team member within an organization that provides the highest quality of care with respect, excellence, and innovation.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Case Management Assistant
CHOC Children’s
11.2019 - 06.2022
- Assist Case Manager for discharge planning and coordination of patient’s health plan and care
- Assist different care teams to achieve daily work such as coordination of patient’s discharge, both inpatient and outpatient, putting DME orders as well as verifying insurances.
- Call Primary Care Physicians to schedule follow up appointments post discharge of hospital including telehealth appointments
- Call PCP to followup on patient care post discharge of hospitalization
- Input data on excel/ update excel spreadsheets
- Input DME’s into Cerner
- Familiar with different home health companies
- Clear e-faxes using Covisint and forward to correct department or Tloor of hospital/ forward e-faxes to patient charts
- Proficient with DME (durable medical equipment) orders
- Call insurances to verify or verify through cerner system
- Faxing/scanning/uploading orders, DME’s
- Work with different inpatient teams and different outpatient teams in different areas of the medical field such as Pulmonary, Oncology, Endocrine, Cranial Facial as well as many other Tields, inputting data, clearing faxes, coordinate the plan of care post discharge, assist with any other areas listed above in the different fields.
- Proficient with whole child model- Caloptima insurance
- Proficient with inputting CCS request/auths through cerner
- Attended regularly scheduled case management and staff meetings.
Medical Assistant
Center for Hypertension & Internal Medicine
08.2008 - 05.2012
- Praised for efficient handling of administration duties such as patient RX refills, educating patients on new medication, educating patients on diabetic care, answering phones, scheduling appointments, maintaining medical records, processing patients, billing, and medical coding.
- Demonstrated proficiency in taking patient medical histories and vital signs as well as performing injections, diagnostic procedures, and ancillary tests such as EKGs, hematology, urinalysis, bone density exams, nerve conduction tests, Electric stimulation, and muscle re-education.
- Ensured the cleanliness, sanitation, and maintenance of all facilities, exam rooms, and equipment.
- Helped implement the practice’s quality assurance and control program. Improved patient satisfaction.
- Reacted calmly and effectively in emergencies and added the personal and caring touch that immediately put patients at ease.
Medical Billing
Center for Hypertension & Internal Medicine
08.2007 - 08.2008
- Utilized ICD-10 CM and HCPS codes for professional providers daily.
- Processed prior authorizations, including physician referrals.
- Ensured prior authorizations were covered and met guidelines.
- Responsibilities included interacting with providers, office staff, medical directors, and health plan employees to ensure a seamless interface between managed care activities and providers.
- Entered procedure codes and diagnosis codes into medical billing software.
- Contacted insurance companies for patient medical billing operations.
- Submitted patient statements and medical billing to insurance companies.
- Maintained knowledge of standardized medical billing codes.
- Supported patients in setting up payment plans and resolving medical billing disputes.
- Obtained essential information from patients, medical records and previous exams for clinical correlation.
- Resolved complex billing and payment issues for balanced, accurate accounts.
Optician
Eyemart Express
01.2005 - 07.2007
- Scheduled appointments, updated system with most recent contact and insurance information
- Performed initial prescreening test, assisted with frame and lens selection that best suited patient’s lifestyle and prescription needs.
- Assisted patients with contact lens insertion and removal.
- Prepared work order
- Dispensed frames, verified prescriptions using automatic lensometer.
- Gained proficiency in adjusting a wide variety of frames to maximize comfort and use.
- Completed daily administrative tasks and maintained multiple eye wear displays.
- Inventoried, reconciled and ordered frames/lenses.
Education
Bachelor of Science - Nursing
West Coast University
Ontario, CA06.2025
AA - Communication, Media and Languages
Norco Community College
Norco, CA06.2019
AA - Humanities, Philosophy and Arts
Norco Community College
Norco, CA06.2019
Skills
MICROSOFT WORD
- EXCEL, OUTLOOK, POWERPOINT
- TYPES BETWEEN 38-40 WPM
- Data entry
- Medical terminology
- Data management
- Medical billing and code software
- Electronic health Records
- Medicare, Medicaid, and private insurance claims
- Insurance terminology
- HIPAA/Patient confidentiality
- Quality assurance
- Interpersonal skills
- Follow-up skills
- Teamwork
- Time management abilities
- Decision-making
- Interdisciplinary teamwork
- Conflict resolution
- Written communication
- Multitasking
- Attention to detail
- Team collaboration
- Customer service
- Medical records review
- Document management
- Continuous improvement
- Excellent communication
- Self motivation
- Life skills development
- Documentation skills
- Case coordination
- Case file management
- Data confidentiality
- Data entry software
Leadership
- Head Athletic Director for Jr All American Football the Eastvale Stallions 2019-2020. I have also been assistant Athletic Director previous years.
- Lead Nurse (Medical Assistant)
- Employee of the Year 2011
Certification
- Registered Nurse: California, License #95429558 Expires December 2026
- CPR certified: Expires 08/2025
- BLS certified: Expires 08/2025
- ACLS certified: Expires 10/2026
Languages
Spanish
Native or Bilingual
English
Native or Bilingual
Timeline
Case Management Assistant
CHOC Children’s
11.2019 - 06.2022
Medical Assistant
Center for Hypertension & Internal Medicine
08.2008 - 05.2012
Medical Billing
Center for Hypertension & Internal Medicine
08.2007 - 08.2008
Optician
Eyemart Express
01.2005 - 07.2007
Bachelor of Science - Nursing
West Coast University
AA - Communication, Media and Languages
Norco Community College
AA - Humanities, Philosophy and Arts
Norco Community College
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