Chronological resume updated ABARBERENA

Chronological resume updated ABARBERENA

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  ARACELLY BARBERENA 15077 SW103RD TERRACE, MIAMI, FL 33196, 305-322-4109, [email protected] OBJECTIVE Licensed Emergency Medical Technician and Medical Assistant professional looking to further her career in the healthcare field. I am dedicated, service-focused and highly motivated to launch a long-lasting career EXPERIENCE 04/25/2016 TO Present CarePlus Health Plans., Inc. Miami, FL CLINICAL GUIDANCE SPECIALIST  Make out bound calls to providers and members to verify clinical information  Research and Document all calls and attach clinical information received and assign to Precertification Nurses, Home Health Specialist and Durable Medical Equipment Specialist.  Create and send out authorization approvals  Data Entry of all authorization requests (office visits, outpatient services, inpatient, diagnostic, durable medical equipment and home health services).  Interact with internal departments such as Grievance and Appeals, Member Services, Social Services, and Quality Services and Case Management 7/01/2015 TO 2/1/2016 Magellan Health Services Miami, FL INPATIENT COORDINATOR  Coordinated activities related to inpatient utilization management.  Obtained Pre- Certifications prior to inpatient admissions and services.  Generated authorizations and scheduling appointments for services needed.  Provided clerical assistance and prepared reports for supervisor.  Generated inpatient denial and letters according to state guidelines  Adhered to company policies, procedures, guidelines and directives while recognizing and enforcing company security measures that comply with HIPPA standards.  Trucare system 11/1/2014 TO 1/1/2015 American Medical Response Doral, FL PRE-BILLING SPECIALIST  Work with Dispatch to provide guidance surrounding non-emergency transports and the paperwork or authorizations needed prior to sending a unit to pick up the patient.  Ensure adequate and appropriate levels of service are dispatched for non-emergency ambulance transports and other requests for service.  Review trailing documents such as hospital facesheets, EKG strips, PCS forms, etc. for appropriate inclusion in the patient care report as well as completeness and accuracy.  Receive real-time notification of high liability clinical areas of concern such as cardiac arrests, missed intubations, cricothyrotomies, etc. to ensure timely review of documentation and provide feedback to crew and/or CES as needed.  Provide clinical feedback to crews and/or CES that elevates the clinical base knowledge of care rendered by crew members including identification of clinically strong documentation, failure to treat patients according to protocol, lack of clinical viewpoint, weak clinical skills, and substandard documentation.  Develop and sustain excellent working relationships with AMR professionals as well as with the Company’s clients, payors, consultants, banks and financial intermediaries and government agencies.
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  5/1/2013 TO 11/1/2014Miami Children’s Hospital Miami, FL CARE ASSISTANT  Assist with procedures and transports as necessary.  Assist and document nutritional and fluid intake and output.  Assist patient with activities of daily living including personal hygiene, nutrition, and comfort measures.  Communicate all significant changes in patient condition or behavior to RN.  Identify the needs of the patient and provide necessary supplies accordingly.  Perform and document vital signs, heights, weights, head circumference and other measurements.  Proactively identify opportunities for improvement, and promotes/practices cost containment.  Provide continuous supervision and observation of patient activities in psychiatric department or inpatient unit as needed.  Recognize accepted priorities for care needs and take direction for re-prioritizing from the RN 9/1/2012 TO 3/1/2014 Miami Dade Ambulance Miami, FL EMT AMBULANCE ATTENDANT  Transport ill, injured, and/or convalescent patients to and from Hospitals, Emergency Rooms, ALFs, SNFs, Urgent Care Centers, Retirement Homes, and Rehabilitation Facilities amongst others.  Accompany and assist EMT on transportation, non-emergency, and 9-1-1 backup service calls.  Administer first aid such as bandaging, splinting, and oxygen administration. Call monitoring and reporting University of Miami 12/1/2010 TO 5/1/2012 Miami, FL Pediatric Oncology Department MEDICAL ASSISTANT/EMT  Scheduling and confirming patient appointments  Manage high-volume clinic phone lines; record, deliver, and follow-up with messages for physicians and nurses  Assist physicians and nurses with patient protected health information including scanning, faxing, and filing as necessary.  Obtain insurance verifications and payor pre-authorizations for treatment.  Perform several clinical duties including but not limited to: taking vital signs, verify glucose levels, inject growth hormones and other medications as ordered. EDUCATION 04/2013-12/2014 City College Miami, FL • Medical Assistant 10/2007-04/2008 City College Miami, FL • Emergency Medical Technician SKILLS • Bilingual; fluent in English and Spanish • Microsoft Suite (Word, Excel, Outlook, PowerPoint) • Cerner- Data Base • UChart- Electronic Health Record system • Kronos- time reporting system LICENSES • CPR Certification • PALS (Pediatric Advance Life Support) Certification • ACLS (Advanced Cardiovascular Life Support)Certification • EMT (Emergency Medical Technician) State Certification # 533499, National Registry # b2030151voc EVOC (Emergency Vehicle Operator) Certification