Polished professional manages multiple tasks, utilizes electronic medical record systems, and provides excellent customer service to patients and staff. Adheres to medical records policies and procedures to comply with HIPAA regulations. Track record of effectively troubleshooting issues and maintaining patient confidentiality. Disciplined individual skilled in collecting and verifying patient demographic and insurance information and preparing and maintaining medical records. Proficient in using medical terminology and classifying diagnostic procedures, treatments and medications. Dedicated to providing highest quality care to patients.
Overview
24
24
years of professional experience
Work History
Nurse Auditor
Insight Service Group, ISG
02.2022 - Current
Improved billing accuracy by conducting thorough medical record audits and identifying discrepancies in documentation.
Enhanced compliance with healthcare regulations by diligently reviewing clinical records and ensuring adherence to guidelines.
Streamlined audit processes for increased efficiency, utilizing electronic health record systems and data analysis tools.
Collaborated with interdisciplinary teams to address issues discovered during audits, contributing to improved patient care outcomes.
Implemented corrective action plans following audit findings, leading to reduced error rates and enhanced revenue recovery.
Educated nursing staff on proper documentation practices through training sessions, resulting in decreased errors and improved overall quality of care.
Conducted regular risk assessments as part of the auditing process, proactively identifying areas requiring intervention or improvement.
Reviewed coding practices for consistency and accuracy, promoting appropriate reimbursement levels for services provided.
Maintained accuracy, completeness, and security for medical records and health information.
Communicated effectively with staff, patients, and insurance companies by email and telephone.
Maintained up-to-date knowledge of regulatory changes impacting the nursing profession, integrating these updates into ongoing auditing activities accordingly.
Managed audit-related projects with tight deadlines, consistently delivering high-quality results on time and within budget.
Medical/Surgical Services Registered Nurse
Charlevoix Hospital
10.1999 - 08.2021
Improved patient outcomes by implementing evidence-based nursing interventions and individualized care plans.
Reduced hospital readmissions through effective discharge planning, patient education, and follow-up care coordination.
Enhanced patient satisfaction by providing compassionate, holistic nursing care that addressed physical, emotional, and spiritual needs.
Streamlined medication administration processes for increased safety and accuracy during busy shifts.
Facilitated patient transitions between different levels of care, ensuring continuity of services and minimizing disruptions in treatment plans.
NIH Scale Certification. Community Health Education experience, organizing and implementing programs designed at improving the health of the surrounding community with the goal of preventing readmission.
Education
Associate of Science - Nursing
Howard Community College
Columbia, MD
Bachelor of Science -
Lake Superior State University
Sault Ste. Marie, MI
Skills
Organizational Abilities
Fraud Detection Techniques
Process Improvement Strategies
Critical Thinking Abilities
Electronic Health Records Navigation
Quality Improvement Initiatives
Clinical Auditing Expertise
Healthcare Compliance Knowledge
Training and Education Abilities
Problem Solving Aptitude
Strong Analytical Skills
Adaptability and Flexibility
HIPAA Regulations Understanding
Timeline
Nurse Auditor
Insight Service Group, ISG
02.2022 - Current
Medical/Surgical Services Registered Nurse
Charlevoix Hospital
10.1999 - 08.2021
Associate of Science - Nursing
Howard Community College
Bachelor of Science -
Lake Superior State University
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