Elizabeth B. Brink
Palm Bay,USA
Summary
Professional with robust experience in clinical review processes, prepared to drive results in healthcare evaluation. Skilled in assessing medical documentation, ensuring regulatory compliance, and providing accurate analysis. Strong focus on team collaboration and adaptability, consistently delivering reliable results. Known for effective communication, problem-solving, and maintaining high standards in dynamic environments.
Overview
11
11
years of professional experience
Work History
Clinical Reviewer
Christian Care Ministry
Melbourne, FL
02.2018 - Current
- Perform and oversee a variety of tasks where the processing and resolution of medical benefits claims or determination of eligibility for sharing benefits is a substantial part of the work.
- Served as a reliable resource for team members seeking guidance or clarification on complex cases, fostering a supportive and collaborative work environment.
- Perform a full range of medical benefits processing assignments and uses judgment in making decisions where alternatives are determined by established policies and procedures.
- Performs case reviews for all ages (including Pediatric/NICU, Maternity, geriatrics, etc)
- Ensured compliance with regulatory requirements through careful adherence to established guidelines and protocols.
- Assisted in the development of quality improvement initiatives, contributing to better patient outcomes.
- Conducted comprehensive evaluations of medical necessity for various treatments, ensuring appropriate allocation of resources.
- Reduced errors in medical documentation through diligent attention to detail and consistent follow-up on discrepancies.
- Demonstrated exceptional organizational skills in managing multiple cases simultaneously while maintaining high levels of accuracy and efficiency.
- Optimized communication within the healthcare team by effectively presenting clinical review findings during meetings and consultations.
- Maintained strict confidentiality regarding sensitive patient information, upholding ethical standards at all times.
- Establishes and revises work methods, forms, formats, and standards to improve operating efficiency.
- Participated in ongoing professional development opportunities to continually expand knowledge and refine skillset as a Clinical Reviewer.
- Used medical and clinical review guidelines and parameters to maintain consistency in MD review process, appropriate utilization levels and compliance with facility policies and procedures.
- Provided training support for new hires entering the role, sharing best practices gleaned from extensive clinical review experience.
- Utilized electronic medical record systems to store, retrieve and process patient data.
- Verified accuracy of patient information in medical records.
- Input data into computer programs and filing systems.
- Followed exact procedures for handling transfers and other releases of medical records.
- Completed detailed documentation for each case reviewed, ensuring clarity for future reference and potential audits.
- Streamlined clinical review processes by implementing efficient data management techniques.
- Supported decision-making processes by providing reliable and timely clinical review findings to supervisors and team members.
- Built relationships, gained alignment for clinical support and articulated questions to receive appropriate level of support from superiors and peers.
Medical Reviewer I / Medical Records Associate
Aerotek
02.2018 - 06.2018
- Reduced record retrieval time by consistently organizing and updating the filing system, improving overall office productivity.
- Facilitated smooth communication between departments by diligently transferring pertinent medical information as needed.
- Collaborated with healthcare professionals to verify patient information, enhancing overall accuracy of medical records.
- Provided exceptional customer service when responding to requests for copies of medical records from patients or legal representatives.
- Conducted regular audits of medical records, ensuring compliance with HIPAA regulations and safeguarding sensitive patient data.
- Coordinated effectively with insurance companies during billing-related inquiries or disputes involving patient medical records.
- Completed high-quality data entry tasks, ensuring accurate input of essential patient details into electronic health record systems.
- Maintained a high level of professionalism and confidentiality when handling sensitive patient information, fostering trust between patients and the healthcare organization.
- Efficiently resolved discrepancies in medical records with attention to detail, ensuring reliable documentation for future reference purposes.
- Actively participated in ongoing training sessions and workshops to stay abreast of industry trends and developments related to medical record management practices.
- Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
- Processed medical records requests from outside providers according to facility, state, and federal law.
- Maintained patient records systems by archiving, scanning and indexing important documents and files.
- Assisted in training new staff on medical record processing and filing procedures.
- Utilized electronic medical record systems to store, retrieve and process patient data.
- Obtained necessary signatures on information release forms to obtain medical and treatment records from other service providers.
Licensed Practical Nurse
Vero Orthopaedics & Neurology
02.2016 - 12.2017
- Managed the Work Comp Medication Program: Including, but not limited to, medication dispensing, dispensing trainer, liaison between state representative for dispensing, maintain up-to-date licensing and reports.
- Provided Stabilization for injured extremities by splinting, casting, and placing in various braces, wound care, staple removal, suture removal
- Knowledgeable in the following medical computer software; NextGen: EHR & EPM, IDS7, MagicWeb: McKesson, Paragon IRMC, MyAncillary, MyDispense: Work Comp, and EForse.
- Improved patient outcomes by administering medications, monitoring vital signs, and documenting relevant information.
- Cared for wounds, provided treatments, and assisted with procedures.
- Assisted with admissions, appointments, transfers, and discharges.
- Managed patient care through closely monitoring respiration, blood pressure, and blood glucose levels.
- Facilitated efficient communication between patients, families, and healthcare providers to promote continuity of care across settings.
- Managed time-sensitive tasks effectively under pressure while maintaining composure during critical situations or emergencies.
- Adapted quickly to changing patient needs, adjusting care plans accordingly to ensure optimal outcomes in diverse clinical scenarios.
- Elevated patient care standards by participating in regular auditing activities within the orthopedic unit to identify areas for improvement.
- Assisted surgeons during orthopedic procedures, ensuring efficient and safe operations.
- Reduced recovery time for patients by providing timely post-operative care and pain management.
- Safeguarded patient privacy rights with strict adherence to HIPAA regulations throughout all interactions.
- Maintained up-to-date knowledge of orthopedic nursing best practices through continuing education courses and professional organization memberships.
- Ensured continuity of care by maintaining accurate documentation and effectively communicating updates to other healthcare professionals.
- Managed complex patient caseloads with a focus on prioritizing needs and coordinating resources to optimize outcomes.
- Provided emotional support for patients coping with chronic pain or facing complex surgeries, enhancing their overall wellbeing.
- Facilitated smooth discharge planning through close coordination with case managers, therapists, and family members.
- Increased patient adherence to treatment plans through clear communication and engagement in shared decisionmaking.
- Promoted a safe environment with diligent infection control measures and strict compliance with safety protocols.
- Optimized resource utilization by managing supplies inventory, anticipating needs, and minimizing waste in the orthopedic unit.
- Developed and delivered in-service training sessions for nursing staff on topics such as wound care, pain management, and orthopedic equipment usage.
- Sustained quality standards by performing routine medication audits and upholding internal and industry best practices.
- Led teams in driving successful patient outcomes by prioritizing standard of care and best practices.
- Conveyed treatment options, diagnosis information and home care techniques to patients and caregivers to continue care consistency.
- Assisted physicians in performing diagnostic tests and procedures to facilitate prompt diagnosis and treatment.
- Leveraged feedback and process improvement opportunities to create safer and healthier environment and increase patient satisfaction.
CNA (Float Student LPN)
Indian River Medical Center
Vero Beach, FL
08.2014 - 02.2016
- Assisted patients with daily living activities, promoting independence and dignity.
- Checked patient vitals such as temperature, blood pressure, and blood sugar levels.
- Promoted infection control practices within the facility by adhering to strict hand hygiene procedures and utilizing personal protective equipment when necessary.
- Documented patient information and care activities in electronic health record.
- Served as a liaison between patients, families, and medical staff to ensure clear communication and understanding of treatment plans.
- Participated in ongoing educational opportunities in order to stay up-to-date on best practices in nursing care.
- Conducted routine safety checks on equipment, promptly reporting any malfunctions or safety concerns to appropriate personnel.
- Assisted in emergency situations under the direction of nursing supervisors or physicians, providing crucial support during life-saving interventions.
- Evaluated patients to identify and address wounds, behavioral concerns, and medically relevant symptoms.
- Enhanced patient satisfaction by providing compassionate and attentive care.
- Maintained confidentiality of patient information according to HIPAA guidelines while communicating effectively with team members about critical updates.
- Delivered individualized patient care by recording vital signs, documenting observations, administering treatments, and evaluating patient needs.
- Served patients in all specialties, such as oncology, orthopedic, medical/surgical, cardiac, PACU, ICU, Labor and Delivery, gynecology, and more!
Education
Licensed Practical Nurse - Nursing
Indian River State College
11.2015
Associates of Science - Nursing
Indian River State College
04.2016
Skills
- Clinical judgment
- Patient confidentiality
- Clinical assessment
- Verbal and written communication
- Compliance management
- Document management/HIPPA compliant
- Adaptability and flexibility
- Organizational skills
- Detail-oriented
- Self motivation
- Medical terminology
- Electronic health records
Timeline
Medical Reviewer I / Medical Records Associate
Aerotek
02.2018 - 06.2018
Clinical Reviewer
Christian Care Ministry
02.2018 - Current
Licensed Practical Nurse
Vero Orthopaedics & Neurology
02.2016 - 12.2017
CNA (Float Student LPN)
Indian River Medical Center
08.2014 - 02.2016
Licensed Practical Nurse - Nursing
Indian River State College
Associates of Science - Nursing
Indian River State College