Marieli Peralta
High Bridge,USA
Summary
Dedicated professional seeking a challenging position in the administrative field. Proven ability to leverage skills and experience to deliver exceptional care and service while fostering a supportive environment.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Certified Medical Assistant
HUNTERDON FAMILY MEDICINE
03.2024 - Current
- Documentation of patients in EMR/EHR systems
- Performance of cognitive and memory tests on patients
- Retrieve and release patient medical records
- Utilized electronic health records software proficiently to input data accurately, facilitating smooth transitions between healthcare providers and insurances criteria.
- Assisted physicians in providing quality care through thorough documentation of medical histories and physical examination results.
- Maintained confidentiality of patient information by adhering to HIPAA guidelines at all times during recordkeeping and communications.
- Coordinated patient referrals to specialists, streamlining communication and improving care continuity.
MEDICAL ASSISTANT
RWJBarnabas Health-DAYTON MEDICAL GROUP
02.2021 - 03.2024
- Assistance with sale representatives
- Track, appeal, and manage denied claims; maintain logs of authorization statuses.
- Manage the full cycle of authorization requests (submission, approval, denial, deferral) for treatments, services, or medications.
- Liaise with physicians, clinical staff, insurance companies, and patients to resolve inquiries and gather missing info.
- Coordinated patient referrals to specialists or other healthcare providers as needed for comprehensive care management plans.
- Assisted with billing and coding processes, ensuring accurate insurance claims and patient invoicing.
- Supported patient well-being, providing empathetic care and addressing concerns with sensitivity.
- Maintained accurate medical records using electronic health record (EHR) systems for compliance purposes.
- Managed communication between healthcare providers and insurance companies to facilitate seamless claim processing.
- Accurately review medical records, clinical data, and diagnosis codes (ICD/CPT) against payer criteria; proficiently use EHR/EMR systems.
- Decreased processing time for authorizations by establishing strong relationships with insurance representatives and case managers.
- Facilitated timely renewals of ongoing authorizations by closely monitoring expiration dates and initiating renewal processes proactively.
- Trained new staff on clinical processes and office protocols, fostering a supportive learning environment.
MEDICAL ASSISTANT AND PHLEBOTOMIST
ADVANCING WELLNESS LLC
11.2019 - 02.2021
- Documentation of patients in EMR/EHR systems
- Accurately performed clerical tasks
- Retrieve and release patient medical records
- Conducted thorough reviews of medical records to identify and address potential issues affecting authorization approvals.
- Collaborated with multidisciplinary teams to ensure timely submission of documentation required for insurance approval.
- Gathered records pertinent to specific problems, reviewed for completeness and accuracy and attached records to correspondence as necessary.
- Coordinated authorization processes to ensure timely approvals for patient services.
- Conducted audits of authorization requests to maintain compliance with regulatory standards.
- Collaborated with interdisciplinary healthcare teams to provide coordinated care.
- Maintained up-to-date knowledge of insurance policies, enabling accurate evaluation of coverage eligibility criteria for patients.
Front and Back Office Lead Medical Assistant
RAHWAY MEDICAL & NEPHROLOGY
02.2019 - 10.2019
- Documenting patient documentation in the EMR/ EHR system
- Assist patients with insurance forms and claims
- Promoted accuracy in coding practices, staying current on ICD-10 changes and industry updates related to medical billing requirements.
- Provided medical billing and coding duties.
- Increased accuracy of medical billing by meticulously verifying proper coding for diagnoses and procedures in patient charts.
- Managed high-volume workload while maintaining exceptional attention to detail for precise data input into the medical billing system.
- Gathered records pertinent to specific problems, reviewed for completeness and accuracy and attached records to correspondence as necessary.
- Read incoming correspondence to ascertain nature of writers' concerns and to determine disposition of correspondence.
- Reviewed authorizations from payer to determine approved or denied items.
- Enhanced communication between healthcare providers and insurance companies, reducing delays in patient treatment approvals.
CERTIFIED MEDICAL ASSISTANT INTERN
EDISON JOB CORPS, EDISON, NJ
12.2017 - 12.2018
- Interviewing patients to obtain medical information
- Promoted office efficiency, coordinating charts, completing insurance forms, and helping patients with diverse needs.
- Led initiatives to maintain compliance with healthcare regulations and standards, ensuring quality care delivery.
- Provided compassionate care for patients, addressing their concerns and ensuring a positive experience.
- Coordinated with other healthcare professionals for patient referrals, ensuring a seamless transition and continuation of care.
- Streamlined communication between healthcare providers, facilitating timely treatment plans and decision making.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Collaborated with medical and administrative personnel to maintain patient-focused, engaging, and compassionate environment.
Education
Food & Nutrition
Hostos Community College
Bronx, NYCertification CCMA & Phlebotomist - Health Science (Nursing)
Edison Job Corps
Edison, NJ12-2018
Associate of Applied Science -
Raritan Valley Community College
Somerville, NJ05-2029
Skills
- Complete tasks in an accurate and timely manner
- Excellent patient advocacy & empathy
- Able to adapt to new situations
- Bilingual (Spanish and English)
- HIPAA compliance
- Medical terminology
- Medical billing and coding
- Attention to detail
- Complex Problem-solving
Certification
- Phlebotomy Technician 2018
- CMA Certificate of Completion & EKG Tech Certified 2018
Timeline
Certified Medical Assistant
HUNTERDON FAMILY MEDICINE
03.2024 - Current
MEDICAL ASSISTANT
RWJBarnabas Health-DAYTON MEDICAL GROUP
02.2021 - 03.2024
MEDICAL ASSISTANT AND PHLEBOTOMIST
ADVANCING WELLNESS LLC
11.2019 - 02.2021
Front and Back Office Lead Medical Assistant
RAHWAY MEDICAL & NEPHROLOGY
02.2019 - 10.2019
CERTIFIED MEDICAL ASSISTANT INTERN
EDISON JOB CORPS, EDISON, NJ
12.2017 - 12.2018
Food & Nutrition
Hostos Community College
Certification CCMA & Phlebotomist - Health Science (Nursing)
Edison Job Corps
Associate of Applied Science -
Raritan Valley Community College