Summary
Overview
Work History
Education
Skills
Websites
Certification
Timeline
Generic

KANESIA QUICKSEY

Pelham

Summary

Results-driven LPN with 20+ years of clinical and administrative healthcare experience in acute care, long-term care, and payer-side operations. Specializes in prior authorization, appeals, and HEDIS abstraction, with a solid understanding of CMS, ERISA, and NCQA requirements. Currently pursuing a Bachelor’s in Healthcare Administration as a Registered Nursing student (Graduation: Dec 2025). Dedicated to improving patient outcomes and health system performance through evidence-based decision-making, quality improvement, and patient advocacy.

Overview

24
24
years of professional experience
1
1
Certification

Work History

Appeals Processing Senior Representative

Cigna Healthcare
01.2018 - Current
  • Manage 50–70 appeals and prior authorizations weekly, maintaining 99% timeliness.
  • Collaborate with MDs and clinical teams to determine medical necessity and coverage.
  • Recognized with 2023 "Excellence in Quality" Award for superior service and accuracy.
  • Reduced case backlog by 30% by developing a real-time tracking system in Excel.

Licensed Practical Nurse

Kirkwood by the River
01.2017 - 01.2021
  • Provided high-quality post-op and chronic disease management for up to 24 residents.
  • Spearheaded fall-prevention program, decreasing falls by 18% within one year.
  • Oriented 8 newly hired LPNs in EMR usage, wound care, and IV protocol compliance.

Licensed Practical Nurse (Med-Surg)

Brookwood Baptist Hospital
01.2002 - 01.2017
  • Delivered bedside care for surgical-medical patients with a 5:1 nurse-patient ratio.
  • Reinforced CLABSI prevention policies—unit achieved zero cases for 18 consecutive months.
  • Participated in the Quality Improvement Council to revise clinical reconciliation policies.

Director / LPN

Blackwell’s Way Group Home
01.2010 - 01.2014
  • Oversaw 25-member interdisciplinary staff and a $500,000 annual budget, with 100% regulatory compliance.
  • Collaborated with psychiatrists to develop behavior plans, reducing incident rates by 25%.
  • Introduced electronic MAR system, improving documentation accuracy by 98%.

Education

A.S. - Nursing

01.2025

B.S. - Healthcare Administration

Rasmussen University
01.2020

Diploma - Practical Nursing

Bevill State Community College
Jasper, AL
01.1998

Skills

  • Prior Authorizations & Appeals (URAC / NCQA)
  • Medicare, Medicaid, & Commercial Insurance
  • HEDIS Data Abstraction & Quality Metrics
  • Clinical Review & Regulatory Compliance (CMS, ERISA)
  • EHR Systems: Epic, Cerner, PointClickCare
  • Remote/Telehealth Clinical Operations
  • Case Management & Patient-Centered Education
  • Workflow Improvement & KPI Dashboards
  • Team Training & Preceptor Mentorship

Certification

  • BLS – American Heart Association
  • CPI – Crisis Prevention & Intervention
  • IV Therapy Certified

Timeline

Appeals Processing Senior Representative

Cigna Healthcare
01.2018 - Current

Licensed Practical Nurse

Kirkwood by the River
01.2017 - 01.2021

Director / LPN

Blackwell’s Way Group Home
01.2010 - 01.2014

Licensed Practical Nurse (Med-Surg)

Brookwood Baptist Hospital
01.2002 - 01.2017

A.S. - Nursing

B.S. - Healthcare Administration

Rasmussen University

Diploma - Practical Nursing

Bevill State Community College