Jane Blevins
Monroe,OH
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level position. Ready to help team achieve company goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
19
19
years of professional experience
Work History
Denials and Appeals Nurse
Ensemble Health Partners
12.2013 - Current
- Evaluated Medical Records, procedures and insurance guideline documents to determine compliance with standards and make effective approval or denial judgments.
- Skilled at working independently and collaboratively in a team environment.
- Self-motivated, with a strong sense of personal responsibility.
Insurance Authorization Specialist
Ensemble Health Partners
12.2013 - Current
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Verified eligibility and compliance with authorization requirements for service providers.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
- Fielded telephone inquiries on authorization details from plan members and medical staff.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Verified client information by analyzing existing evidence on file.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
Registered Nurse- STNA Instructor
Greentree Academy
07.2013 - 01.2014
- Reviewed STNA course content with students to pass the State Nursing assistant state test.
- Provided guidance and instruction to students during clinical
- Review policy and procedure of various basic STNA skills.
LPN Charge Nurse
Scarlet Oaks Retirement Home
01.2013 - 10.2013
- Assessed patients' temperature, pulse, and blood pressure and recorded in electronic medical records.
- Delivered direct quality care to patients by evaluating medical conditions and managing and assessing treatments.
- Established cordial relationships with medical personnel and staff to promote teamwork and maintain positive attitude.
- Assembled and used equipment such as catheters, tracheotomy tubes, or oxygen suppliers to effectively manage patient care.
- Assisted in coordinating transfers, discharges and admissions to establish smooth transition of patients.
- Maintained and promoted autonomy and rights of patients to provide protection and enforce dignity and respect.
- Analyzed patient assessments and laboratory data to bring any issues to attention of physicians.
- Collaborated with interdisciplinary teams to establish proper patient care and provide education to patients and family members.
- Educated patients to provide information on health promotion and disease prevention.
- Promoted patient independence by teaching self-care skills and explaining conditions and medications.
- Participated in development and implementation of quality improvement initiatives to raise healthcare standards.
- Reviewed patient history to verify conditions and current medications.
- Worked with multidisciplinary team to carry out successful treatment plans for diverse acute and chronic conditions.
- Evaluated patient histories, complaints, and current symptoms.
- Helped long-term care residents with bathing, dressing, feeding, and other daily living activities.
- Provided patient education on health care issues and prescribed medications.
- Clearly and thoroughly explained diagnoses, treatment options and procedures to patients and loved ones, checking in to verify understanding.
- Helped patients complete bathing, dressing and eating.
- Developed and implemented individualized patient care plans.
- Protected patients and healthcare team members from infection by sterilizing equipment and reusable supplies.
LPN Field Nurse
Heartland Of Woodridge
08.2012 - 10.2013
- Cared for wounds, provided treatments, and assisted with procedures.
- Assisted with admissions, appointments, transfers, and discharges.
- Documented accurate and complete patient information to address patient problems and expected outcomes.
- Managed patient care through closely monitoring respiration, blood pressure, and blood glucose levels.
- Performed routine evaluations of each patient's status, needs, and preferences.
- Administered controlled narcotics, inserted IVs, and performed catheterizations.
- Monitored, tracked, and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
- Used aseptic techniques to provide sterilized wound care and dressing applications.
- Evaluated patients to identify and address wounds, behavioral concerns, and medically relevant symptoms.
- Clearly and thoroughly explained diagnoses, treatment options and procedures to patients and loved ones, checking in to verify understanding.
- Helped long-term care residents with bathing, dressing, feeding, and other daily living activities.
- Provided patient education on health care issues and prescribed medications.
- Delivered emotional support to patients and families during challenging times.
- Worked with multidisciplinary team to carry out successful treatment plans for diverse acute and chronic conditions.
- Provided diagnosis information, treatment possibilities, disease management tips and wound care advice to patients, loved ones and caregivers.
- Circulated assigned floor to measure and record patients' fluid and food levels, implementing measures to promote healthy intake and output as necessary.
- Managed various general office duties such as answering multiple telephone lines, completing insurance forms, and mailing monthly invoice statements to patients.
- Supported diagnoses by taking blood samples from patients for laboratory testing.
- Developed and implemented individualized patient care plans.
- Protected patients and healthcare team members from infection by sterilizing equipment and reusable supplies.
- Helped patients complete bathing, dressing and eating.
- Obtained patient vital signs and input/output measurements from inpatients.
- Responded to patient requests with appropriate clinical and personal assistance.
- Evaluated patient histories, complaints, and current symptoms.
- Reviewed patient history to verify conditions and current medications.
- Assessed patients' temperature, pulse, and blood pressure and recorded in electronic medical records.
- Monitored patient health conditions to report changes to assigned physician.
- Administered medications and injections to patients.
- Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
- Minimized staff and patient infection risk by cleaning and disinfecting equipment instruments.
- Offered immediate assistance in emergency and routine paging situations to evaluate needs and deliver care.
- Delivered updates in patient status to charge nurse, recording changes in medical records.
- Answered incoming phone calls from patients to provide basic assistance and triage medical concerns.
- Comforted and counseled patients and families throughout care process.
- Educated patients and caregivers on medical diagnoses, treatment options, chronic disease self-management and wound management.
- Collaborated with interdisciplinary team of healthcare and social service providers to address patients' needs through effective intervention and care planning.
LPN Charge Nurse
Franklin Ridge Nursing Home
08.2004 - 04.2011
- Assessed patients' temperature, pulse, and blood pressure and recorded in electronic medical records.
- Delivered direct quality care to patients by evaluating medical conditions and managing and assessing treatments.
- Established cordial relationships with medical personnel and staff to promote teamwork and maintain positive attitude.
- Assembled and used equipment such as catheters, tracheotomy tubes, or oxygen suppliers to effectively manage patient care.
- Assisted in coordinating transfers, discharges and admissions to establish smooth transition of patients.
- Maintained and promoted autonomy and rights of patients to provide protection and enforce dignity and respect.
- Analyzed patient assessments and laboratory data to bring any issues to attention of physicians.
- Documented patient care plans and progress to enable tracking history and maintain updated records.
- Educated patients to provide information on health promotion and disease prevention.
- Collaborated with interdisciplinary teams to establish proper patient care and provide education to patients and family members.
- Promoted patient independence by teaching self-care skills and explaining conditions and medications.
- Updated patient medical records with services provided, health conditions, and response to treatments using [Software].
- Delivered emotional support to patients and families during challenging times.
- Administered medications and injections to patients.
- Led and mentored [Number] newly licensed nurses and nursing students to develop professional expertise.
- Monitored patient health conditions to report changes to assigned physician.
- Helped long-term care residents with bathing, dressing, feeding, and other daily living activities.
- Evaluated patient histories, complaints, and current symptoms.
- Reviewed patient history to verify conditions and current medications.
- Worked with multidisciplinary team to carry out successful treatment plans for diverse acute and chronic conditions.
- Participated in development and implementation of quality improvement initiatives to raise healthcare standards.
- Managed daily staff assignments and patient scheduling to guarantee clinic coverage and flow.
- Responded to patient requests with appropriate clinical and personal assistance.
- Provided patient education on health care issues and prescribed medications.
Education
Associate of Applied Science - Nursing Science
Galen College of Nursing
Cincinnati, OH04.2012
LPN - LPN
Butler Technology And Career Development Schools
Hamilton, OH05.2003
Skills
- Microsoft Access
- Management of Personnel Resources
- Negotiate Settlements
- Learning Strategies
- Microsoft PowerPoint
- Critical Thinking
- Time Management
Licensures
- Registered Nursing RN. 396941 Issued 10/07/2013
Timeline
Denials and Appeals Nurse
Ensemble Health Partners
12.2013 - Current
Insurance Authorization Specialist
Ensemble Health Partners
12.2013 - Current
Registered Nurse- STNA Instructor
Greentree Academy
07.2013 - 01.2014
LPN Charge Nurse
Scarlet Oaks Retirement Home
01.2013 - 10.2013
LPN Field Nurse
Heartland Of Woodridge
08.2012 - 10.2013
LPN Charge Nurse
Franklin Ridge Nursing Home
08.2004 - 04.2011
Associate of Applied Science - Nursing Science
Galen College of Nursing
LPN - LPN
Butler Technology And Career Development Schools
Similar Profiles
Sharon SmithSharon Smith
Coding Specialist 1, Billing, Denial Specialist at Mercy Health Partners/Ensemble Health PartnersCoding Specialist 1, Billing, Denial Specialist at Mercy Health Partners/Ensemble Health Partners
Samantha MarlattSamantha Marlatt
Specialized Mentor And Revenue Cycle Trainer at Ensemble Health Partners-OU Health /Ardent HealthSpecialized Mentor And Revenue Cycle Trainer at Ensemble Health Partners-OU Health /Ardent Health
Maydey AcostaMaydey Acosta
HIM Specialist at Ensemble Health Partners (Nicklaus Health Client)HIM Specialist at Ensemble Health Partners (Nicklaus Health Client)
Lynice MurrayLynice Murray
Spec Patient Access/ Financial Counselor at Ensemble Health Partners/ Bon Secours Mercy HealthSpec Patient Access/ Financial Counselor at Ensemble Health Partners/ Bon Secours Mercy Health
Jessica JohnsonJessica Johnson
Benefits Specialist at Macy's Inc.Benefits Specialist at Macy's Inc.