Amrissia Wortham
Licensed Practical Nurse
Arcadia,LA
Summary
I am fast learning, eager and goal oriented. I am always willing to go above and beyond. With the proper training, I aim to fulfill this position above exceptional standards. Willing to relocate: Anywhere Authorized to work in the US for any employer.
Overview
17
17
years of professional experience
6
6
Certifications
1
1
Language
Work History
Medical Review Nurse
Blue Cross and Blue Shield of Louisiana
09.2024 - Current
- Reviews medical claims and requests for services and applies medical judgment and/or criteria in determining the benefits for pre-services and post-services according to contractual benefits and limitations (i.e., contractual exclusions, cosmetic procedures, medical necessity, and administrative discrepancies) to ensure the proper administration of contractual and medical limitations/exclusions.
- Prepares documentation of medical information, completes research, makes recommendations, and refers potential denials to the Medical Directors and Management, when necessary, to ensure compliance with URAC standards, MNRO and DOL laws and regulations.
- Completes correspondence correctly when necessary to providers and subscribers to ensure that customers are aware of the determinations and appeal processes/rights meeting all regulatory standards.
- Meets targeted expectations for staff and unit performances as required by BCBSLA and department management.
- Collaborates with team members and communicates to the supervisor suggestions for improvement to ensure adherence to the corporate initiative of diversity
Physician Substitute (LPN)
ImmunoTek Bio Centers, LLC
11.2023 - 08.2024
- Enhanced clinic efficiency by managing patient flow and ensuring timely appointments.
- Provided compassionate care to patients while addressing their concerns and answering questions about treatments.
LPN
SnapNurse
08.2023 - 10.2023
- Demonstrating solid experience in medication administration, vital signs, condition assessment, wound/trach care, catheter placement, patient data documentation, and daily living support.
- Interacting effectively and efficiently with doctors, peers, patients, and families to assess needs, identify appropriate treatments, and achieve goals.
- Demonstrating superior leadership, time management, and organizational skills.
- Utilizing warm, friendly, and articulate communication style to establish trusting patient and peer relationships.
Licensed Practical Nurse
Willis Knighton Health System
10.2022 - 06.2023
- Demonstrating solid experience in medication administration, vital signs, condition assessment, wound/trach care, catheter placement, patient data documentation, and daily living support.
- Interacting effectively and efficiently with doctors, peers, patients, and families to assess needs, identify appropriate treatments, and achieve goals.
- Demonstrating superior leadership, time management, and organizational skills.
- Utilizing warm, friendly, and articulate communication style to establish trusting patient and peer relationships.
- Facilitate referrals and linkage to community and social resources.
- Work with all clinical teams as a key resource in care management
- Contact patients to ensure compliance with treatment plans and proactively eliminate potential or actual barriers.
- Partnering with patients to establish goals, and action steps and develop individualized care plans.
- Collaborate with patients, their physician(s), and other care team members to monitor progress toward goals.
- Develop a keen understanding of urology practice and best practices.
- Ensure effective outreach for recommended care and continuity of services.
- Provide patient education to increase understanding of disease processes and promote self-management.
- Regularly attends and participates in meetings with coworkers and practice staff.
- Collaborate with payer Case Managers for additional services when appropriate.
- Perform all job functions in compliance with applicable federal, state, local, and company policies and procedures.
LPN Care Coordinator
Medical Temps, Inc
08.2021 - 10.2022
- Responsible for the effective and sufficient support of all Case Management activities to include review of inpatient and outpatient medical records for appropriateness of case management resources.
- Uses an established set of criteria to evaluates and approve the necessity of case management services rendered.
- Provide notification of decisions in accordance with compliance guidelines.
- Participation in staff meetings, regular trainings and other collaborative meetings as appropriate.
- Works with management team to achieve operational objectives and financial goals.
- Supports teams across CM Department and throughout Clinical Operations as needed.
- Active participation and completion of all required trainings.
- Maintain Required Licensures.
- Adherence to regulatory and departmental timeframes for review of requests
- Meet/exceed department Turn Around time, daily established productivity goals, and management of medical cases
- Proficient knowledge of policies and procedures, Medicare, HIPAA and NCQA standards
- Professional demeanor and the ability to work effectively within a team or independently
- Flexible with the ability to shift priorities when required
- Obtains client information by answering telephone calls; interviewing clients; verifying information.
- Determines eligibility by comparing client information to requirements.
- Establishes policies by entering client information; confirming pricing.
- Informs clients by explaining procedures; answering questions; providing information.
- Maintains communication equipment by reporting problems.
- Maintains and improves quality results by adhering to standards and guidelines; recommending improved procedures.
- Updates job knowledge by studying new product descriptions; participating in educational opportunities.
- Accomplishes sales and organization mission by completing related results as needed.
Travel Nurse
SnapNurse
04.2021 - 07.2021
- Vaccination assignment, includes but not limited to: assessing and collecting patient history and allergies, Administration of Covid-19 vaccines, monitoring for adverse reactions.
LPN (Licensed Practical Nurse)
Lincoln Community Health Center
10.2019 - 04.2021
- Triage patients
- Reconcile medications
- Perform in clinic procedures
- Set follow up appointments
- Schedule transportation for patients
- While under the direction of a MD. Initiate telephonic visits and triage patients remotely.
- Request Prior Authorizations from various Health insurance companies.
Student
Louisiana State University
08.2018 - 08.2019
- Licensed practical nurse
- Demonstrating solid experience in medication administration, vital signs, condition assessment, wound/trach care, catheter placement, patient data documentation, and daily living support.
- Interacting effectively and efficiently with doctors, peers, patients, and families to assess needs, identify appropriate treatments, and achieve goals.
- Demonstrating superior leadership, time management, and organizational skills.
- Utilizing warm, friendly, and articulate communication style to establish trusting patient and peer relationships.
Facilitator/Supervisor
Southern Ingenuity
09.2017 - 07.2018
- Facilitators are directly in charge of assigned consumer needs within that consumer's homes. They are supervisory staff that are in charge of several employees. They must be able to travel throughout the parishes in which Southern Ingenuity provides services to ensure all needs of the consumers are met.
Assistant Manager
Courtesy Loans
04.2016 - 08.2017
- Providing exceptional customer service
- Maintaining office cash with accuracy and security
- Achieving account gain through proven loan judgment and effective customer solicitation
- Ensuring compliance with state and federal lending regulations and Company policies
- Ensuring prompt completion of loan applications
- Ensuring compliance with company record keeping procedures
Teller
Capital One Bank
12.2013 - 04.2016
- Provides account services to customers by receiving deposits and loan payments; cashing checks; issuing savings withdrawals; recording night and mail deposits; selling cashier's checks, traveler's checks, and series e bonds; answering questions in person or on telephone; referring to other bank services.
Store Trainer
Brookshire's Grocery Company
09.2009 - 12.2013
- Prepares new sales representatives by conducting orientation to sales process; developing individual coaching plans; providing resources and assistance; scheduling orientation drive-along with senior representatives.
Education
Certificate - Nursing
Louisiana State University at Shreveport
Shreveport, LABachelor of Science - Nursing
Grambling State University
Grambling, LAHigh school diploma - undefined
Athens High School
05.2011
Skills
- Patient Care
- Vital Signs Monitoring
- Electronic Health Records
- HIPAA Compliance
- Medical Terminology
- Documentation Accuracy
- Infection Control
Certification
Epic Certification
Timeline
Medical Review Nurse
Blue Cross and Blue Shield of Louisiana
09.2024 - Current
Physician Substitute (LPN)
ImmunoTek Bio Centers, LLC
11.2023 - 08.2024
LPN
SnapNurse
08.2023 - 10.2023
Licensed Practical Nurse
Willis Knighton Health System
10.2022 - 06.2023
LPN Care Coordinator
Medical Temps, Inc
08.2021 - 10.2022
Travel Nurse
SnapNurse
04.2021 - 07.2021
LPN (Licensed Practical Nurse)
Lincoln Community Health Center
10.2019 - 04.2021
Student
Louisiana State University
08.2018 - 08.2019
Facilitator/Supervisor
Southern Ingenuity
09.2017 - 07.2018
Assistant Manager
Courtesy Loans
04.2016 - 08.2017
Teller
Capital One Bank
12.2013 - 04.2016
Store Trainer
Brookshire's Grocery Company
09.2009 - 12.2013
Certificate - Nursing
Louisiana State University at Shreveport
High school diploma - undefined
Athens High School
Bachelor of Science - Nursing
Grambling State University