Cristina Andrea Betito
El Paso,TX
Summary
Detail-oriented nurse with strong skills in patient advocacy, teamwork, and documentation accuracy. Experienced in developing individualized care plans and implementing infection control measures to improve patient outcomes and safety.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Hemodialysis Nurse
Innovative Renal Care
El Paso, TX
06.2023 - Current
- Administered hemodialysis treatments to patients, ensuring adherence to safety protocols and patient care standards.
- Monitored vital signs and patient responses during dialysis sessions, promptly addressing any complications.
- Educated patients on treatment processes, dietary restrictions, and lifestyle modifications to enhance health outcomes.
- Provided emotional support to patients and families coping with the challenges of chronic kidney disease, fostering a positive treatment experience.
- Developed strong rapport with patients through active listening skills and empathy, promoting trust in their healthcare providers.
- Assessed patient's vital signs before, during, and after dialysis treatments, ensuring prompt intervention in case of any complications.
- Improved patient outcomes by closely monitoring laboratory results and adjusting treatment parameters accordingly.
- Reduced infection rates by adhering to strict aseptic techniques and maintaining a clean, sterile environment for dialysis procedures.
- Safeguarded patient safety by promptly identifying potential contraindications or allergies prior to initiating hemodialysis treatments.
- Administered medications and treatment to patients and monitored responses.
- Explained course of care and medication side effects to patients and caregivers in easy-to-understand terms.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
Utilization Review Nurse
Cognizant Technologies Solutions
Manila, Philippines
11.2021 - 03.2023
- Reviewed and assessed medical necessity for authorization requests, ensuring compliance with regulations.
- Collaborated with healthcare providers to gather clinical information and facilitate care coordination.
- Contributed to team success by consistently meeting productivity goals while maintaining high-quality standards in job performance.
- Performed Workers’ Compensation Utilization Management reviews in accordance with federal and state mandated regulations. Maintains compliance with regulatory changes affecting utilization management.
- Performed WCUM reviews (prospective/concurrent/retrospective) for inpatient/ outpatient services according to the URAC standards and client requirements and/or policies.
- Reviewed WCUM requests for services against established clinical review criteria, referring cases not meeting criteria to a physician reviewer.
- Adhered to Department of Labor, state and company WCUM timeframe requirements.
- Communicated with claims adjusters and/or providers on requests that needs verification.
- Certified reviews that meet clinical review criteria/guidelines.
- Adhered to quality standards and state UM guidelines.
- Maintained all required utilization management review documentation in the UM software in a timely manner.
- Responded to inbound telephone calls pertaining to WCUM reviews in a timely manner, following client-established protocols.
- Maintained confidentiality of all information, policies, and procedures as required by HIPAA protocols.
- Performed assigned tasks or work queues to assure cases are handled timely as well as meet established timelines for urgent requests.
- Adhered to Utilization Review Accreditation Commission (URAC), jurisdictional, and/or established best practice WCUM time frames, as appropriate.
Hemodialysis Nurse
Hemotek Renal Center
Manila, Philippines
08.2019 - 08.2022
- Trained new nursing staff on dialysis procedures, equipment use, and patient management best practices.
- Evaluated treatment efficacy through regular patient follow-ups, anemia management and laboratory draws.
- Assisted in managing inventory of medical supplies and equipment used in hemodialysis procedures, ensuring availability and compliance with standards.
- Optimized resource utilization by minimizing waste disposal and efficiently managing medical supplies inventory within the unit.
- Mentored new nurses entering the field of hemodialysis nursing, sharing expertise and knowledge to enhance their competency levels.
- Participated in continuous professional development opportunities, staying up-to-date on best practices in nephrology nursing.
- Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
- Evaluated patient histories, complaints, and current symptoms.
- Monitored patient reactions after administering medications and IV therapies.
- Administered hemodialysis treatments to patients, ensuring adherence to safety protocols and patient care standards.
- Monitored vital signs and patient responses during dialysis sessions, promptly addressing any complications.
- Developed strong rapport with patients through active listening skills and empathy, promoting trust in their healthcare providers.
- Reduced infection rates by adhering to strict aseptic techniques and maintaining a clean, sterile environment for dialysis procedures.
- Educated family members and caregivers on patient care instructions.
Outpatient Medical Coder
Armco Healthcare Services Inc.
Manila, Philippines
04.2017 - 06.2019
- Reviewed and coded outpatient medical records for accuracy and compliance with industry standards.
- Trained junior coders on best practices, coding guidelines, and software utilization.
- Ensured adherence to regulatory requirements by staying updated on changes in coding policies and guidelines.
- Contributed to the growth of the organization by consistently meeting or exceeding productivity targets while maintaining high-quality standards.
- Enhanced accuracy by implementing thorough medical record reviews and diagnostic coding.
- Maintained up-to-date knowledge of industry trends and changes in coding guidelines, providing ongoing education to colleagues as necessary.
- Upheld strict confidentiality policies regarding sensitive patient information while adhering to HIPAA requirements.
- Participated in continuous learning opportunities, staying current on advances in medical science and evolving industry standards that impact outpatient coding practices.
- Served as a subject matter expert within the team on specific coding specialties, offering guidance and support when needed.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Verified signatures and checked medical charts for accuracy and completion.
- Maintained accuracy, completeness, and security for medical records and health information.
Inpatient Medical Coder
Miramed LLC
Manila, Philippines
11.2016 - 04.2017
- Reviewed and analyzed medical documentation for accurate coding assignments.
- Ensured compliance with coding regulations and guidelines to maintain quality standards.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Enhanced coding accuracy by meticulously reviewing patient records and applying correct medical codes.
- Utilized electronic medical record systems to store, retrieve and process patient data.
Prior Authorization Representative
Accenture
Manila, Philippines
03.2014 - 11.2016
- Coordinated prior authorization requests to ensure compliance with regulatory requirements.
- Reviewed medical documentation for accuracy and completeness before submission to payers.
- Communicated effectively with healthcare providers to gather necessary information for approvals.
- Mentored junior staff on best practices for handling complex authorization cases.
- Provided exceptional customer service, addressing inquiries from both patients and healthcare providers promptly and professionally.
- Ensured compliance with HIPAA regulations by maintaining strict confidentiality in handling sensitive patient information.
- Verified eligibility and compliance with authorization requirements for service providers.
- Reduced claim denials by thoroughly reviewing and analyzing medical necessity documentation before submitting for approval, ensuring all criteria were met.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Maintained patient confidentiality and safeguarded medical records to avoid information breaches.
- Achieved high customer satisfaction ratings by providing timely updates to patients and healthcare providers on the status of their requests.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Organized and detail-oriented with a strong work ethic.
Customer Service Representative
Teleperformance
Manila, Philippines
04.2013 - 02.2014
- Resolved customer inquiries through effective communication and problem-solving techniques.
- Managed customer accounts, ensuring accurate updates and timely responses to service requests.
- Analyzed customer feedback to identify trends and implement improvements in service quality.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Responded to customer requests for products, services, and company information.
- Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
- Improved resolution time with effective problem-solving for customer complaints.
Education
Bachelor of Science - Nursing
Far Eastern University- Dr. Nicanor Reyes Medical Foundation
Quezon City, Philippines04-2011
Skills
- Adaptable Decision-making
- Patient monitoring
- Vascular Access care
- Patient and family advocacy
- Documentation accuracy
- Fluid and medication management
- Dialysis machine operation
- HIPAA compliance
- Infection control practices
- Teamwork and collaboration
- Deep knowledge of medical terminology, anatomy, and surgical techniques
- Critical Thinking & Problem Solving
Affiliations
AHIMA, AHA
Certification
- Active RN license state of Illinois, Unemcumbered
- Active RN license state of Texas, Unencumbered
- Certified Coding Specialist (CCS) since 01/2026
- BLS provider until 04/2027
- Certified Professional Coder (CPC) September 2016-2019 (not renewed)
Languages
English
Full Professional
Timeline
Hemodialysis Nurse
Innovative Renal Care
06.2023 - Current
Utilization Review Nurse
Cognizant Technologies Solutions
11.2021 - 03.2023
Hemodialysis Nurse
Hemotek Renal Center
08.2019 - 08.2022
Outpatient Medical Coder
Armco Healthcare Services Inc.
04.2017 - 06.2019
Inpatient Medical Coder
Miramed LLC
11.2016 - 04.2017
Prior Authorization Representative
Accenture
03.2014 - 11.2016
Customer Service Representative
Teleperformance
04.2013 - 02.2014
Bachelor of Science - Nursing
Far Eastern University- Dr. Nicanor Reyes Medical Foundation