BRITTANY HANSELMAN
Summary
Experienced in managing prior authorization processes and ensuring regulatory compliance. Utilizing patient advocacy skills and effective communication, I streamline approval procedures. Proficient in healthcare protocols, I excel in collaborating with multidisciplinary teams for optimal patient care.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Medical Review Specialist – Registered Nurse
Avosys Technologies
10.2021 - 03.2025
- Conducted clinical reviews of Medicare Part A and Part B claims, prior authorizations in alignment with CMS regulations, including LCDs, NCDs, and IOM guidance.
- Assessed medical documentation for medical necessity, accuracy, and compliance with Medicare guidelines, including proper provider signatures and required supporting records.
- Completed case reviews within established CMS timeframes, utilizing electronic decision tools to document rationale for approvals, reductions, or denials.
- Proactively identified potential barriers to approval, implementing strategies to address these challenges before they impacted patient care.
- Expedited urgent requests for prior authorization, ensuring timely access to critical medical treatments.
Hospice Nurse
VITAS Inpatient Hospice Unit
01.2021 - 10.2021
- Coordinated with interdisciplinary teams to develop and implement individualized care plans.
- Assisted with post-mortem care and collaborated with city officials and facilities.
- Improved patient comfort by providing compassionate end-of-life care and symptom management.
- Managed pain effectively by closely monitoring symptoms and adjusting medications accordingly.
- Advocated for patients'' wishes regarding medical treatment options, respecting cultural beliefs and values throughout the decision-making process.
Registered Nurse – Medical-Surgical/Intensive Care Unit
University Health Systems
06.2018 - 01.2021
- Collaborated with interdisciplinary teams to optimize treatment plans and improve patient outcomes.
- Educated patients and families on post-discharge care, medication adherence, and disease management.
- Conducted ongoing monitoring of vital signs, lab results, and diagnostic tests to promptly identify changes in patient conditions.
- Assisted with critical procedures, including arterial cut-downs, central line insertions, and endotracheal tube placements.
- Managed critical care patients with complex medical conditions, providing compassionate care and support to families.
- Responded efficiently to medical emergencies within the hospital setting, providing life-saving interventions as needed.
Education
Bachelor of Science - Nursing
University of The Incarnate Word
San Antonio, TX05.2018
Skills
- Clinical review proficiency
- Prior authorization expertise
- Healthcare compliance proficiency
- Discharge Planning & Care Coordination
- Evidence-based clinical evaluation
- Medical record management and adherence
- Clear communication with stakeholders
- Quality control and fraud mitigation
- Regulatory compliance expertise
- Teamwork and collaboration
- Knowledge of HIPAA regulations
- Analytical reasoning
Certification
Registered Nurse (RN), Texas Board of Nursing
Timeline
Medical Review Specialist – Registered Nurse
Avosys Technologies
10.2021 - 03.2025
Hospice Nurse
VITAS Inpatient Hospice Unit
01.2021 - 10.2021
Registered Nurse – Medical-Surgical/Intensive Care Unit
University Health Systems
06.2018 - 01.2021
Bachelor of Science - Nursing
University of The Incarnate Word
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