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Skills

  • Breastfeeding education
  • Records maintenance
  • Cross-functional collaboration
  • Strong presentation skills
  • Emergency Medical Technician (EMT) certification
  • Diabetes and nutrition education
  • BAC screening/drug screen collection
  • Healthy meal preparation
  • Family planning services education
  • Lab result interpretation

Work Experiences

  • Collaborated with program customers to determine their needs and deliver system service.
  • Checked service providers' eligibility and compliance with authorization requirements.
  • Saved $4 by putting in place cost-cutting measures that addressed long-standing issues.
  • Looked for industry trends on social media and through online sources.
  • Requests for nonstandard services were escalated to category personnel in cross-functional collaboration.
  • Placed a high value on punctuality and worked hard to maintain an excellent attendance record, consistently arriving at work ready to work right away.
  • Looked over insurance coverage for patients to see who was responsible for payment.
  • Authored standard operating procedures (SOPs) for the prior authorization team, resulting in a 72% process improvement.
  • Wrote and distributed denial letters outlining the reasons for the denial as well as possible appeal options.
  • Achieved departmental goals by collaborating cross-functionally to address authorizations that exceeded one year.

Summaries

  • Bilingual Certified Nursing Assistant with 10 years of tracheotomy care experience.
  • Professionally, she is known for being a strong advocate and communicator.
  • Team player with experience leading nursing teams and coordinating patient care for adolescent to geriatric patients.
  • While assisting doctors, she is skilled at quickly setting up rooms and closely monitoring vitals.
  • Surgical procedures, restocking supplies, and updating electronic health records are all things that she can help with.
  • Professional who is well-organized and familiar with regulatory standards and compliance requirements.
  • Successful in advocating for the needs of patients and obtaining quick diagnoses.
  • Dedicated to learning, growing, and succeeding in Healthcare.
  • In program environments, a caring Quality Improvement Coordinator is passionate about maximizing patient care standards.
  • Prior Authorization Specialist with 18 years of successful strategic planning and budget management experience.

Accomplishments

  • Treated
  • Surgical Preparation: Assisted in patient surgery preparation by administering proper medication, monitoring patients' conditions and charting abnormalities.
  • Instructed
  • Patient Education: Educated patients about medical procedure steps, recovery measures and medication instructions.
  • Recognized
  • Surgical Preparation: Prepared patients for surgery by performing screening tests, evaluating vitals and administering proper medication.
  • Promoted
  • Process Executed full patient assessments, including category and standard.
  • Procedure Properly disposed of daily biohazard waste in compliance with federal and local regulations.
  • Clinical Services: : procedure method Policy Development:: framework standard Total Quality Management:: procedure process

Affiliations

  • Project Management Institute (PMI) - Project Management Professional (PMP) (2020)
  • Sigma Theta Tau International (Nursing Honor Society)
  • Insurance Institute of America (IIA) - Healthcare-Related Certifications
  • Certification in Prior Authorization by method
  • National Healthcareer Association (NHA)
  • American College of Healthcare Executives (ACHE)
  • Certified Healthcare Access Associate (CHAA) 2023
  • Educational Seminars by system
  • American Academy of Professional Coders (AAPC)
  • Association for Supply Chain Management (APICS)

Certifications

  • Cisco Certified Internetwork Expert (CCIE)
  • Certified Public Accountant (CPA)
  • Pediatric Education for Prehospital Professionals (PEPP)
  • Prehospital Trauma Life Support (PHTLS)
  • ANA Certified in School NP
  • First Aid/CPR Certified
  • Apple Certified Associate (ACA)
  • Graduate Certificate in Global Health
  • Advanced Cardiac Life Support (ACLS) Certification standard
  • Certified Electronic Health Records Specialist (CEHRS)

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