Detailed Registered Nurse committed to never letting vital requests or documents go unprocessed. Diligent tracker of patient outcomes and caretaker feedback. Incorporates empathetic communications with professional best practices to satisfy plan members and business goals alike.
Authorized outpatient elective procedure requests in accordance with applicable plan guidelines.
Tracked referral submission during facilitation of prior authorization issuance.
Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
Verified eligibility and compliance with authorization requirements for service providers.
Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
Fielded telephone inquiries on authorization details from plan members and medical staff.
Created and maintained spreadsheets detailing all medical procedures, including applicable denials and approvals.
Coordinated patient scheduling, check-in, check-out and payments for billing.
Contacted hospitals to confirm patients medical histories and prevent inaccurate diagnoses and treatments.
Organized paperwork such as charts and reports for office and patient needs.
Completed skilled administrative work to support all office staff and operational requirements.
Maintained office supplies inventory by checking stock and ordering new supplies as needed.
Received, recorded and addressed incoming and outgoing communication via telephone and email.
Supported providers in outpatient medical office through coordinating all administrative operations.
11/2014 to 08/2019
RN-Charge for Transitional Care UnitClark Regional Medical Center – City, STATE,
Conferred with physicians to discuss diagnoses and devise well-coordinated treatment approaches.
Delivered medications via oral, IV and intramuscular injections, monitoring responses to address new concerns.
Provided direct patient care, stabilized patients and determined next course of action.
Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
Gathered lab specimens, ordered testing and interpreted results to diagnose patients.
Reviewed post-operative orders and continuously monitored patients' post-operative vitals, set up PCA and fluids and oriented patients to unit to achieve optimal outcomes.
Motivated nursing staff to pursue advanced training and collaborated with unit leaders to identify skill needs.
Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process and management and lifestyle options.
Secured controlled narcotics and distributed medication on schedule to meet patient needs and minimize misuse opportunities.
Advised patients and caregivers of proper wound management, discharge plan objectives, safe medication use and disease management.
Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
02/2010 to 11/2014
RN Unit Manager Windsor Care Center – City, STATE,
Conferred with physicians to discuss diagnoses and devise well-coordinated treatment approaches.
Performed ongoing assessments to evaluate mental health needs, working with multidisciplinary team to develop, initiate, manage and modify individualized plans of care.
Audited charts and reviewed clinical documents to verify accuracy.
Developed strategy to target nursing and patient satisfaction issues, improve response and patient care quality and suggest actionable improvements to promote hospital-wide quality and safety initiatives .
Supervised professional and paraprofessional nursing staff and delegated tasks to maintain continuum of care.
Coordinated and implemented in-service educational programs focusing on safety and adherence to protocols.
Collaborated with leadership to devise initiatives for improving nursing satisfaction, retention and morale.
Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process and management and lifestyle options.
Kept optimal supply levels in treatment rooms, triage and other areas to meet typical patient loads.
Observed and reported patient condition, progress and medication side effects to accurately document updates.
Provided direct patient care, stabilized patients and determined next course of action.
Secured controlled narcotics and distributed medication on schedule to meet patient needs and minimize misuse opportunities.
Promoted professional development opportunities to encourage nurses to pursue continuous training.
Motivated nursing staff to pursue advanced training and collaborated with unit leaders to identify skill needs.
Collaborated with interdisciplinary healthcare personnel to meet patients' personal, physical, psychological and cognitive needs.
Education
Expected in 12/2009
Associate of Science: Nursing Eastern Kentucky University - Richmond, KY, GPA:
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