LPN Resume Example
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LPN
Professional Summary
- 6 years of clinical nursing experience in assisted living/nursing home,hospital in psychiatric/detox as well as OBGYN, L&D.
- 4 years private duty/in home nursing for brain injury and spinal cord patients.
- 4 years administrative nurse experience in HEDIS, medical abstraction manually and electronically, MDS code-compliance and administrative training of nurses and CNA's in various areas.
- 9+ years in managed care corporate insurance experience in consulting, presentations, implementation, eligibility, enrollment, as well as HIPAA administration.
- 2 years experience as a Licensed Insurance Agent with in depth knowledge of insurance and finance portfolio.
Licenses
Licensed Practical Nurse in the State of [Georgia], License number [LPN083203] since 2010
Licensed Insurance Agent in the State of [Georgia], License number
[2930078]
CPR certified through American Heart Association since 2010
Pediatric Life Support (PALS) Certification since 2010
Skill Highlights
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Professional Experience
LPN04/2015Wexford Health Sources IncCamp Verde , AZ
- Admission, assessment and discharge of adult, elderly, and pediatric patients.
- CPI trained.
- Extensive experience in psychiatric, mental health, DD.
- Full monitoring and care of patients.
- Administering all medications and carried out all doctor orders for patients, performed vital signs and all nursing skills including but not limited to catheterization, wound care, IV infusion, PICC line, trach and vent experience.
- Fully knowledgeable in all injections and immunizations and reactions to such injections accordingly. Thorough knowledge in medications.
- Recorded patients' medical history, vital statistics and test results in medical records.
HEDIS Nurse (Current BCBS of GA) + HEDIS Abstractor/Educator01/2013CareNational Healthcare Services, Inovalon Health, Integration Health Services STATE
- Collected, researched and organized information to use in reviews.
- Reported reviews not meeting criteria to peer consultants, including medical directors.
- Maintained complete confidentiality of protected health information.
- Communicated with management regarding development within areas of assigned responsibilities.
- Gathered, entered, and analyzed data.
- Performed Medical Reviews in Physicians offices throughout the state.
- Educated provider and office staff about medical records and clinical standard guidelines.
- Assisted in defining opportunities for improvement through analysis of patterns and trends.
- Communicated significant findings, including potential risk management issues to the Quality Management.
- Performed on-site medical record reviews.
- Adhered to established procedures for scheduling, requesting, and reviewing records while on-site at provider offices and hospitals.
- Ability to collected from medical records, immunization registries, member documents and provider office
- Excellent interpersonal and organizational skills
- Effective problem solving, analytic and communication skills
- Professional phone etiquette
- Amazing ability to demonstrate appreciation of cultural diversity and sensitivity towards target population
- Remarkable ability to work calmly and effectively under adverse conditions
Psychiatric/Detox and Maternity LPN01/2011 to 12/2014Hamilton Medical CenterCity , STATE
- Admission, assessment and discharge of adult, maternity, pediatric patients.
- CPI trained.
- Extensive experience in psychiatric, mental health, DD.
- Full monitoring and care of patients and babies.
- Administering all medications and carried out all doctor orders for patients, performed vital signs and all nursing skills necessary
- Thorough knowledge in medications.
- Recorded patient's medical history, vital statistics and test results in medical records.
Employer Services Consultant/HIPAA Administrator11/1998 to 12/2008CIGNA HealthcareCity , STATE
- Administrator and educator for new business accounts from implementation to their eligibility, billing, structure and account maintenance.
- Data Entry quality 98.8%.
- Processed applications, payments, made corrections, processed endorsements and cancellations.
- Promoted products to customers in person, on the telephone and in writing.
- Prepared necessary paperwork to process insurance eligibility, sales and renewals.
- Presented and clearly explained insurance policy options to clients based on their needs and goals.
- Coded claims forms and mediated disputes between carriers and clients.
- Promoted client retention, quality and measurement goals through high-quality service, educating and follow through.
- Handled processing and shipping of all certificate of creditable coverage letters issued for CIGNA enrollees.
- Received all certificate of creditable coverage letters to CIGNA and performed all calculations for pre-existing conditions and limitations.
- Held seminars at CIGNA and client businesses on overall HIPAA compliance.
- Pursued continuing education and training programs to continue professional development.
Education and Training
Insurance and Finance2014FX Insurance CompanyCity, State, US
Online course program used for educational requirements to sit for Insurance Agent Bar of Georgia.
LPN: Nursing2010Dalton State CollegeCity, State, US
Coursework in [RN and LPN] respectively.
Focus on College: High School1990Ridgeland High SchoolCity, State, US
Regular high school education with college prep.
References
References Available Upon Request
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Resume Overview
School Attended
- FX Insurance Company
- Dalton State College
- Ridgeland High School
Job Titles Held:
- LPN
- HEDIS Nurse (Current BCBS of GA) + HEDIS Abstractor/Educator
- Psychiatric/Detox and Maternity LPN
- Employer Services Consultant/HIPAA Administrator
Degrees
- Insurance and Finance 2014
LPN : Nursing 2010
Focus on College : High School 1990
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