Jean Brustkern
Spokane,WA
Summary
Accomplished Clinical Review Nurse and HUC with a proven track record at Kaiser Permanente, adept in analytical thinking and team building. Excelled in performing medical necessity reviews and coordinating patient care, demonstrating EPIC software proficiency and exceptional organizational skills. Achieved significant improvements in patient data accuracy and interdepartmental communication efficiency.
Overview
12
12
years of professional experience
Work History
HUC
MultiCare Deaconess Hospital
Spokane, WA
12.2020 - Current
- Coordinated communication between various departments within the facility regarding patient care needs.
- Assisted with scheduling appointments for patients and doctors.
- Managed and updated patient records with attention to confidentiality and accuracy in a fast-paced environment.
- Communicated with patients with compassion while keeping medical information private.
- Organized patient records, charts, and other documents in an orderly manner.
- Collaborated with interdisciplinary teams in the development and implementation of patient care plans.
- Maintained inventory of medical supplies and equipment, placing orders as necessary to ensure availability.
- Managed daily operations of the health unit including filing, faxing, photocopying.
- Communicated with patients and medical staff to convey important information and facilitate smooth unit operations.
- Performed clerical tasks such as typing letters, memos, and reports as requested by management.
- Answered incoming calls and routed them to the appropriate departments or staff members.
- Provided administrative support to healthcare teams, including data entry, filing, and preparing reports.
- Provided administrative support to nursing staff as needed.
- Answered and directed incoming calls, providing information or taking messages as appropriate for efficient communication.
- Processed paperwork related to hospital admissions, discharges, and transfers.
Clinical Review Nurse
Kaiser Permanente
Spokane, WA
02.2013 - 06.2019
- Performed medical necessity reviews of inpatient and outpatient services to ensure compliance with relevant regulations and standards.
- Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
- Interpreted insurance contracts related to payment provisions for services rendered by providers.
- Maintained up-to-date knowledge on changes in healthcare industry regulations.
- Conducted utilization management activities such as pre-certification and pre-authorization requests for services rendered by health care providers.
- Consulted with physicians regarding appropriate documentation requirements when necessary to support clinical decision making.
- Evaluated appeals from denied claims per applicable state and federal laws.
- Reviewed patient records for accuracy, completeness, timeliness, and appropriateness of care prior to authorization requests.
- Assessed clinical data from multiple sources including but not limited to medical records, lab results, radiology reports, medication administration records.
- Interpreted and evaluated diagnostic tests to identify and assess patient's condition.
Education
Graduate Certificate - Vocational Nurse
Hawkeye Community College
Waterloo, IA01-1973
Skills
- Analytical thinking
- Problem-solving
- Social perceptiveness
- Team building
- Time management
- EPIC Software Proficiency
- Good Telephone Etiquette
- Organization and time management
- Supervision and leadership
- Attention to detail
- Problem resolution
- Customer service
- Flexible and adaptable
Affiliations
- Love to Quilt
- Love of travel
Timeline
HUC
MultiCare Deaconess Hospital
12.2020 - Current
Clinical Review Nurse
Kaiser Permanente
02.2013 - 06.2019
Graduate Certificate - Vocational Nurse
Hawkeye Community College
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