- Conduct comprehensive health risk assessments for Medicare beneficiaries
- Educate and counsel on preventative care to promote healthy lifestyle
- Manage documentation and medical records in compliance with CMS guidelines
- Collaborate with healthcare providers to enhance patient care through effective communication and teamwork
- Provided case management services to patients with chronic medical conditions
- Developed and maintained relationships with clients and their families
- Actively monitored patient progress and provided appropriate resources to maximize quality of care
Prior Authorization Nurse
- Streamlined prior authorization process for Prolia/Evenity for 20+ family medicine providers
- Identified inaccuracies in billing and introduced measures to balance cost-effectiveness
- Created unique workflow process to ensure successful and timely authorizations
- Conducted thorough medical record review in compliance with health plan protocols
- Provided exceptional customer service to patients and collaborating staff