Elba Peralta

Bilingual Professional with specialties in Medical Billing and Customer Service

*** ******* **

Quincy, MA 02170

917-***-****

ad1wza@r.postjobfree.com

EXPERIENCE

Order Processing/Customer Service Agent

Foundation Medicine - Cambridge, MA

July 2021-November 2021

Temporary assignment for the very well respected biotech company Foundation Medicine. In this position I processed lab orders for testing and lab work up for our clients.That was the main function along with taking daily calls from physicians, nurses, and even patients to give information on everything from results, to what stage of testing they were in, to processing time.

● Maintained metrics on a daily basis for orders

processed and calls taken.

● Performed daily data entry for orders

● Maintained metrics for phone calls processed

● Managed client records including editing and upkeep of correct client information

● Answering client and patient inquiries in most efficient way possible

● Maintaining 100% accuracy on all orders and requests processed

MassHealth Customer Service and Enrollment

Specialist

PCG, Inc. - Medford, MA

May 2019 to March 2020

Project for MassHealth to assist with enrollments and re enrollments. We processed over 100 enrollments,

recertifications,renewals, and all forms pertaining to member services on a daily basis.

• Performed data entry for customer information

• Managed client records efficiently

• Assisted customers with a warm and professional

attitude

• Answered general questions on coverage

• Proficient in MassHealth and Medicare software

• Maintain an 80% and above accuracy rating

• Team collaboration to solve software and member

issues

SKILLS

VIRTUAL GATEWAY (7 years)

50 WPM (10+ years)

OPTUM (7 years)

CLAIMS PROCESSING (5

years)

HIPPA CERTIFIED (7 years)

BILINGUAL (SPANISH) (10+

years)

MASSHEALTH/MEDICAID (7

years)

THIRD PARTY BILLING (5

years)

HCFA (5 years)

DATA ENTRY (10+ years)

CUSTOMER SERVICE ( 10+

years)

CALL CENTER (10+ years)

HEALTHCARE SOFTWARE (7

years)

TEAM LEAD/PEER COACH (2

years)

EPIC (5 years)

SALESFORCE (5 years)

MEDICAL TERMINOLOGY (10

years)

AWARDS

11 awards for top rep at

Verizon

5 Outstanding Customer

Service Awards at Comcast

LANGUAGES

SPANISH-Fluent

A/R Representative & Medicare Claims Processor

Advant-Edge

September 2017 to December 2018

Processing daily recharges along with daily charges

● Processing denials

● Processing appeals

● Processing write offs

● Recoding procedures that had errors using ICD-10

● Make sure all accounts were documented and written up properly especially when it

● came to refunds along with scanning in all documents

● Process credits and debits on accounts according to Medicare guidelines

● Proficient in MassHealth and Medicare software

● Strong knowledge of other Insurance carriers

● Strong knowledge of third party billing

Medical Biller

Anesthesiology Department Medical Biller Lawrence General Hospital - Lawrence, MA

September 2016 to September 2017

Anesthesiology

● Processing daily charges in a 100% accuracy

● Scanning in all dates of services for prior day for processing

●Strong team communication daily by emails and calls

● Sending out insurance forms weekly to Mass Health

● Recoding IDC-10 and CPT codes that were processed in error Medical Customer Service Representative

Beacon Health Strategies

June 2013 to August 2016

● Verifying insurance through MassHealth website or by calling insurance directly to find out coverage dates

● Setting up appointments for nurses and CNAs to visit their patients

● Calling outpatient facilities to check availability for clients

● Bilingual translations either by phone or email to the patients who only spoke

● Bilingual processing and appointment setting

Inside Sales Executive

Comcast - North Reading, MA

November 2011 to June 2013

Setting up new phone Internet and cable service

● Efficiently solving all Billing issues

● Accurately troubleshooting Repair issues

● Collaborating with clients in Collections

● Number one in sales over 10 times in my 2 years with the company awarded with certificates

● Bilingual customer service

Billing Specialist

Tufts Medical Center

November 2010 to February 2011

● Responsible for daily charge entry for GMA Tufts this included reading the report

● Coding appropriately and in order of importance

● Collaborating with in house billing department on discrepancies

● Final reviews to send out to bill insurances would all be approved through me

● In charge of all missing charges to be entered into database to be kept track of by management

● Responsible for all end of the month budgeting and projected figures

Customer Sales & Service Associate

Verizon

December 2003 to August 2006

● Number one sales rep 11 months in a row

● Achieved diamond club awards first year and platinum the second year

● Received numerous customer recognitions for excellent service

● Promoted to team leader by the second year

● Daily calls included everything from billing questions, to payment arrangements

● Excellent services for customers and even technical support if needed.

EDUCATION

Certificate in Medical Billing & Coding

Kaplan Institute - Boston, MA

July 2010 to June 2011

High School Diploma

ICHS - Lodi, NJ

1995-1999

**Currently only 5 credits shy of receiving my Bachelor’s Degree

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