Experienced Registered Nurse with over 10 years of experience in Healthcare and Third Party Insurance Disability. Excellent reputation for resolving problems, using clinical knowledge, natural interpersonal strengths and technical abilities. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Knowledgeable about EMR charting, medication administration and interdisciplinary collaboration focused on optimizing patient care and support. Quality-focused and efficiency-driven leader.
Performing clinical reviews of referred claims
Documenting decision rationale and completing medical review of all claims to ensure information substantiates disability.
Provides clear and appropriate follow-up recommendations for ongoing medical management of claims.
Ensures appropriate recommendations are made on claims.
Selected for WalMart COVID Team to assist in bringing over 500,000 backlogged claims current.
Working in collaboration with examiners to support and offer resources and assistance in performance of duties related to claims management to maintain high-quality and efficient claim handling.
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