Analyzed clinical data submitted by physician offices in order to approve or deny prior authorization requests.
Evaluates the pre-service authorization request received for scheduled inpatient admissions, ambulatory surgeries, and outpatient services, and out-of-network providers.
Accurate, thorough, and efficient review of authorization request.
Reviews prior authorization request with medical directors, as directed.
Utilize effective communication, courtesy, and professionalism in all interactions, both internally and externally.
Cardiovascular ICU RN
Philippine Heart Center
Quezon City, Philippines
11.2016 - 05.2022
Experienced in working with cardiac monitors, defibrillators, mechanical ventilators, temporary pacemakers, arterial lines, intra-aortic balloon pumps, and pulmonary artery catheters.
Knowledgeable with medication administration and computation, such as Epinephrine, Norepinephrine, Dopamine, Dobutamine, Vasopressin, Adenosine, Amiodarone, Diltiazem, Nitroglycerin, and Lidocaine.
Proactively monitored telemetry monitors to identify cardiac rhythm irregularities and promptly implement necessary interventions.
Assisted physicians during insertion and removal of endotracheal tube, central line, arterial line, and chest tube.
Performed bedside procedures, such as endotracheal tube suctioning, nasogastric tube placement, or urinary catheter placement.
Conducted diagnostic tests, including EKGs, arterial blood gas and venous blood gas analysis, as well as lab work, and able to interpret abnormal results.
Functioned as a charge nurse. Maintained a safe environment for the ICU staff and patients by ensuring that all safety protocols were followed consistently.
Medical Surgical RN
Philippine Heart Center
Quezon City, Philippines
10.2015 - 11.2016
Worked in a medical-surgical ward, providing care for 7-10 patients with various cardio-pulmonary illnesses, such as coronary artery disease, congenital heart defects, infective endocarditis, myocardial infarction, and valvular diseases.
Experienced in preparing patients who will undergo cardiac procedures such as coronary angiography, percutaneous coronary intervention, CABG, valve surgeries, temporary pacemaker insertion, embolectomy, and amputations.
Managed time efficiently by prioritizing tasks based on acuity levels of assigned patients.
Observed proper documentation of patient assessments, treatments, medications, and progress notes.
Educated patients and their families on disease management and lifestyle modifications.
Staff Nurse I
East Avenue Medical Center
Quezon City, Philippines
09.2012 - 12.2013
Managed pre-operative preparations for surgeries such as hysterectomies or cesarean sections.
Managed emergency situations, such as pre-eclampsia, eclampsia, and postpartum hemorrhage.
Educated parents on newborn care, breastfeeding techniques, and postpartum recovery.
Coordinated discharge planning, including follow-up appointments and home care instructions.
Deputy General Manager – Operations at Sagility India Private Limited (formerly Hinduja Global Solutions)Deputy General Manager – Operations at Sagility India Private Limited (formerly Hinduja Global Solutions)