Summary
Overview
Work History
Education
Skills
References
Timeline
Generic

Kathy Wilcox

New Smyrna Beach,FL

Summary

Dedicated Medical Review Authorizations Nurse with expertise in clinical documentation, care coordination, and patient advocacy. Committed to ensuring regulatory compliance and enhancing patient outcomes.

Overview

1
1
year of post-secondary education
23
23
years of professional experience

Work History

Medical Review Authorizations Nurse

Florida Healthcare Plans
Daytona Beach, Florida
09.2007 - Current

Checked member eligibility, gathered clinical records, compiled clinical data for review, processed approvals, wrote denial letters, and communicated with members about benefits, approvals, denials, medical conditions, and healthcare options.

  • Managed multiple tasks, prioritizing urgent requests from physicians and nurses to ensure timely care delivery.
  • Assisted in coordinating care between multiple departments effectively.
  • Participated in quality improvement initiatives to enhance patient outcomes and streamline care processes.
  • Advocated for patients by supporting and respecting basic rights, values, and beliefs.
  • Ensured compliance with safety and health regulations consistently.
  • Provided guidance to new employees regarding policies and procedures within the organization.
  • Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
  • Worked towards departmental goals by implementing new care processes. and objectives by instituting new processes and standards for in-patient care.

Admissions Director

Horizon Healthcare
Daytona Beach, Florida
05.2003 - 08.2007
  • Managed team of admissions counselors to improve application processing efficiency.
  • Developed strategic admissions plans to enhance enrollment at Horizon Healthcare.
  • Collaborated with academic departments to align programs with student needs.
  • Oversaw compliance with regulatory requirements in the admissions process.
  • Created marketing materials such as brochures, fliers, newsletters. to promote the school's offerings.

Education

LPN - Licensed Practical Nurse

Daytona State College
Daytona Beach, FL
08.1999 - 08.2000

Skills

  • Clinical documentation
  • EHR management
  • Medical review processes
  • Regulatory compliance
  • Care coordination
  • Patient advocacy
  • Florida nursing license
  • Effective communication
  • Problem solving
  • Time management
  • Conflict resolution
  • Healthcare ethics

References

References available upon request.

Timeline

Medical Review Authorizations Nurse

Florida Healthcare Plans
09.2007 - Current

Admissions Director

Horizon Healthcare
05.2003 - 08.2007

LPN - Licensed Practical Nurse

Daytona State College
08.1999 - 08.2000
Kathy Wilcox