Elisa Brister
Orange Park,FL
Summary
Accomplished Nurse Auditor with a proven track record at Baptist Health Medical Center, enhancing nursing audit policies and fostering interdepartmental collaboration. Expert in healthcare compliance and critical thinking, streamlined audit processes, and improved coding accuracy. Skilled in electronic health records and data analysis, with efforts consistently aligned with industry standards and boosted organizational efficiency.
Overview
15
15
years of professional experience
Work History
Nurse Auditor
Baptist Health Medical Center
06.2022 - Current
- Assisted in developing policies and procedures related to nursing audits, ensuring organizational alignment with industry standards.
- Reviewed coding practices for consistency and accuracy, promoting appropriate reimbursement levels for services provided.
- Streamlined audit processes for increased efficiency, utilizing electronic health record systems and data analysis tools.
- Served as a liaison between clinical departments during audits, fostering collaborative relationships that supported effective problem-solving efforts.
- Team identified over $100.000.00 of missed revenue
Travel Nurse
Aya Healthcare
03.2022 - 06.2022
- Delivered high-quality patient care during emergency situations, remaining calm under pressure and effectively prioritizing tasks according to urgency.
- Improved patient outcomes through careful monitoring and thorough documentation of vital signs, medical histories, and treatment plans.
- Administered medications and treatment to patients and monitored responses.
- Assessed patient conditions by taking vital signs and evaluating symptoms to determine appropriate treatment.
- Post-surgical unit
Clinical Nurse Coordinator
HCA Florida Orange Park Hospital
07.2021 - 03.2022
- Mentored and supervised nursing staff, fostering professional growth and development.
- Managed staffing needs by creating schedules, adjusting assignments based on patient acuity levels, and delegating tasks efficiently.
- Facilitated timely discharge planning by collaborating with patients, families, and healthcare providers.
- Demonstrated commitment to ethical decision-making in all aspects of clinical practice, prioritizing patient safety and well-being.
- Directed day-to-day nursing and operational functions for an 18-bed nursing behavioral/telemetry unit, ensuring exceptional delivery of care when developing well-rounded nursing teams.
Clinical Review Nurse
Novitas Solutions
08.2018 - 07.2021
- Reviewed and made medical determinations as to the validity of health claims and levels of payment in meeting national and local policies as well as accepted medical standards of care.
- Applied clinical knowledge to assess the medical necessity, level of services, and appropriateness of care which may include cases requiring prior authorization, complex pre-payment medical review, or post-payment medical review.
- Guided other team members and accurately interpreted and applied broad CMS guidelines to specific and highly variable situations.
- Conducted review of claim data and medical records to make clinical decisions on the coverage, medical necessity, utilization, and appropriateness of care per national and local policies, as well as accepted medical standards of care.
- Reviewed provider practices and identified issues of concern, overpayment, and need for corrective action as necessary; including surfacing potential fraud, abuse, or practice concerns.
- Developed recommendations for further corrective action based on medical review findings.
Registered Nurse
HCA Orange Park Medical Center
Orange Park , FL
02.2017 - 08.2018
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Worked well in a team setting, providing support and guidance.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Relief Charge Nurse
- Certified Preceptor
Pediatric Home Health LPN
Integrity Health Services
Jacksonville , FL
10.2009 - 02.2017
- Enhanced patient comfort by providing compassionate care and addressing individual needs.
- Promoted effective communication among healthcare providers, patients, and families to ensure seamless coordination of care.
- Collaborated with case managers to recommend appropriate community resources for continued patient support after discharge from home health services.
- Pediatric medically complex care
- Ventilator and trach management
- IV certified
Education
Doctor of Nursing Practice - Education
Chamberlain University
Downers Grove, IL07.2025
Master of Science - Nursing
Chamberlain University
Downers Grove, IL02.2022
Bachelor of Science - Nursing
Chamberlain University
Downers Grove, IL04.2019
Skills
- HIPAA Regulations Understanding
- Healthcare Compliance Knowledge
- Critical thinking abilities
- Organizational abilities
- Strong analytical skills
- Electronic health records navigation
- Data Analysis Capabilities
- Performance metrics evaluation
- Fraud detection techniques
- Clinical Auditing Expertise
- Regulatory Guidelines Adherence
- CMS guidelines
Affiliations
- AAPC
- AHIMA
- HFMA
Timeline
Nurse Auditor
Baptist Health Medical Center
06.2022 - Current
Travel Nurse
Aya Healthcare
03.2022 - 06.2022
Clinical Nurse Coordinator
HCA Florida Orange Park Hospital
07.2021 - 03.2022
Clinical Review Nurse
Novitas Solutions
08.2018 - 07.2021
Registered Nurse
HCA Orange Park Medical Center
02.2017 - 08.2018
Pediatric Home Health LPN
Integrity Health Services
10.2009 - 02.2017
Doctor of Nursing Practice - Education
Chamberlain University
Master of Science - Nursing
Chamberlain University
Bachelor of Science - Nursing
Chamberlain University
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