Coordinates and directs the activities of a unit of Claims Adjusters/Examiners/Investigators to ensure that operational objectives are met in terms of the quantity, quality and timeliness of work performed.
Analyzed case management data to enhance evaluation process for claims examiners aligned with performance benchmarks and program goals. Collaborated with claims examiners to clarify performance expectations, fostering improved communication. Achieved improved performance feedback through quarterly assessments delivered to each claims examiner. Implemented corrective actions effectively to address performance gaps as needed.
Reviews case files at various points in the development and adjudicative process to ensure that all actions taken are appropriate and adhere to the rules of Process Unification. Assesses a variety of documents in the case file to determine evidentiary sufficiency and compliance with Social Security law and regulations.
Coordinates training for new and experienced claims examiners in the unit. Provides ongoing training for claims examiners as required to explain new or revised medical, vocational and technical instructions, or to reinforce previously acquired knowledge. Assists in the area office training.
Oversaw daily operations to ensure compliance with disability determination processes.
Registered Nurse, Pre-op/PACU
Southeastern Urology Center
Tallahassee, FL
01.2011 - 01.2016
Admitting patients into the Outpatient surgical area, including assessment and intervention.
Post Anesthesia care in the outpatient setting, including assessment and intervention, pain management and education
Started a Pre-Anesthesia assessment program for a specific segment of our patient population, including gathering information and educating patients on procedures, allowing our schedule to run more efficiently
Evaluated patient responses to treatments, adjusting care plans as necessary to ensure effectiveness.
Conducted thorough assessments of patients' conditions, ensuring accurate documentation and reporting to medical teams.
Collaborated with interdisciplinary teams to develop comprehensive treatment plans for complex patients with multiple comorbidities.
Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
Registered Nurse, Labor and Delivery
Tallahassee Memorial Healthcare
Tallahassee, FL
01.2004 - 01.2014
Provided professional nursing care within the unit.
Communicating and coordinating care with other disciplines.
Rendered individualized, age specific and direct bedside nursing care based on the nursing process and patient needs.
Worked within a team in the OR during cases specific to the area.
Provided support for patients and families dealing with perinatal bereavement.
Acted as a charge nurse, including delegating responsibility and being available to assist other providers and offer guidance.
Mentored new nursing staff in labor and delivery protocols, fostering a culture of excellence and teamwork.
Responded to emergency situations such as pre-eclampsia, early labor, and fetal distress.