Adaptable healthcare professional with over 20 years of experience, accustomed to the continuous integration of new health care delivery systems and restructuring of work in an increasingly complex regulatory environment. Strong relationship and leadership building skills with an excellent reputation for resolving problems, improving customer satisfaction, and driving overall operational improvements.
Skills
Independent judgment and decision making
Medical education/terminology
Quality improvement competency
Strong presentation skills
EMR/EHS experience
Clinical documentation and auditing
Data assessment/analysis
Well-versed in insurance
Problem resolution
MS Office
Excellent multi-tasking ability
Staff Management
Organizational skills
Interdepartmental Communication
Medicare
Information Systems
Accurate Documentation
Management
Work History
Rehabilitation Admissions Coordinator, 04/2009 - Current State Of Oklahoma – Mangum, OK,
Direct interaction with case managers, Physicians, and potential clients to achieve needed services for acute rehabilitation
Engagement/education of staff on admission criteria and Medicare compliance
Planning and achievement of goals/ objectives through continuous quality improvement initiatives
Initiation and cultivation of long term relationships by reviewing customer survey information to prioritize areas of improvement
Assessment of information for identifying clients who would benefit from services offered by the facility using EMR (EPIC/Soarian), in person or telephone interviews with patients and family members
Market rehab program by providing informational brochures, conducting tours, and visiting facilities for the cultivation of prospective clients
Initiation of the audit process to evaluate the thoroughness of documentation and maintenance of facility standards
Ad hoc report preparation- collecting, analyzing, summarizing data trends to improve patient outcomes and facility growth
Oversight of all aspects of data collection for Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI), ensuring the presence of supporting documentation, correct coding, and timely submission to Centers for Medicaid and Medicare Services (CMS)
Verification of insurance prior to admission from private insurance carriers or Medicare/Medicaid
Continuous oversight of unit census while adhering to Medicaid compliance.
Maintain unit census at or above 90% while consistently reviewing patient acuity
Continual improvement of knowledge, skills, and performance-based on feedback and self-identified professional developmental needs
Assisted inpatient admission process based on federal and state laws
Team Lead Manager, 03/2008 - 03/2009 Medassurant – City, STATE,
Supervised and managed daily activities of Data Analysis team consisting of 12-15 nurses and coders
Prepared work schedules and assigned duties for abstraction of high volumes of medical records to ensure correct and appropriate code assignment using International Classification of Diseases edition 9 (ICD-9) and Current Procedural Terminology (CPT) coding
Achieved high staff morale and retention through effective communication, prompt problem resolution, proactive supervisory practices and facilitation of proactive work environment
Interpreted and communicated new or revised policies to maximize department effectiveness
Completed quality, accuracy and inter-rater reliability testing with a goal of 100% accuracy
Reviewed and interpreted medical terminology through knowledge of anatomy and physiology with the ability to code diseases and procedures using ICD-9 and CPT coding
Measured team performance and reported metrics to leadership team members
Evaluated employee performance monthly and coached and trained accordingly, increasing quality of work and employee retention
Reviewed performance data to monitor and measure productivity, goal progress and activity levels
Licensed Practical Nurse II, 04/1998 - 03/2008 Washington Hospital Center Obstetrics/Gynecology – City, STATE,
Continuous observation of patients, updated medical records, reported changes in patients conditions, such as adverse reactions to medication or treatment, and took necessary actions to prevent complications of treatment of care
Member of the health care team providing assessment of patient/family needs, implementation of interdisciplinary team care plan, and evaluation of nursing outcomes
Obtained client medical history, including medication information, symptoms and allergies.
Monitored, tracked and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
Complied with all company-specific guidelines and performed hands-on nursing care to patients under RN supervision.
Collaborated with interdisciplinary team of healthcare and social service providers, including Physicians, Case managers and Ancillary medical staff to address patients' needs through effective intervention and care planning.
OB Nurse Care Manager, 06/2007 - 11/2007 Unity Health Care – City, STATE,
Assessed healthcare needs and monitored effectiveness and progress plans to achieve desired outcomes
Offered leadership, support and clinical expertise within care management teams to achieve outcomes
Identified opportunities to optimize communication within inpatient and cross-continuum teams to drive effective patient flow and sustainable care transitions from hospital and home, within community care settings and implement supplemental care and services for high-risk patients
Facilitated assessment of individual physiological, psychological, financial, cultural and family situation and coordinated social services to address individual and family needs
Communicated with patients, ensuring that medical information was kept private
Offered patients and patrons information on various immunizations including flu, DTaP and HPV vaccines
Coordinated referrals to specialists, hospitalizations, ER visits, ancillary testing and other enabling services for patients
Education
Bachelor of Science: Healthcare Administration, Expected in - Colorado Technical University - Colorado Springs, CO GPA:
Certification: Licensed Practical Nursing, Expected in - Saint Augustine Technical Center - St. Augustine, Fl., GPA:
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