Heather Wallace (Rivera)

Trained in antepartum, intrapartum, postpartum care while rotating to triage, resource/circulator, and baby nurse.

Utilizing strong critical thinking skills in responding to emergencies such as high risk pregnancies, postpartum hemorrhage, and neonatal resuscitation.

Supported physicians and patients in high risk deliveries, in addition to, planned and emergency Cesarean section procedures.

Collaborated with interdisciplinary healthcare team members, including physicians, neurosurgeons, nurse practitioners, physical therapists, occupational therapists, speech therapists, and social workers, to coordinate patient care and achieve optimal outcomes.

Skilled in providing patient and family education regarding neurological and medical conditions, medications and their side effects, rehabilitation exercises, follow up appointments, and strategies for promoting optimal health and preventing complications.

Ability to think critically and make rapid, accurate decisions in emergency situations, such as cardiac arrest, respiratory distress, neurological deterioration, acute neurological changes, and other medical emergencies, utilizing advanced life support whilst communicating with teams, physicians, and management.

Obtaining authorizations in Inpatient, Outpatient, Labor and Delivery, Pediatric Infusion, Surgery, Radiology, and Specialty Pharmacy services.

Expertise of medical terminology, coding, procedures, clinical and insurance guidelines, while effectively liaising with healthcare providers, policyholders, and insurance professionals to complete prior authorizations.

Effectively managing a high volume of authorizations, referrals, and appeals while evaluating trends in authorization denials to identify areas for improvement in both internal processes and external communications with payers.