Kelly Smith
Jasper
Summary
Meticulous professional specializing in dispute resolution, quality assurance, and team collaboration. Demonstrates expertise in refining review processes and ensuring compliance through precise documentation and impactful communication.
Overview
20
20
years of professional experience
Work History
Dispute Resolution Reviewer
J29
Millersville
06.2023 - Current
- Reviewed documents for accuracy and compliance with company standards.
- Collaborated with team members to improve review processes and workflows.
- Provided constructive feedback on submissions to enhance quality and clarity.
- Utilized digital tools to track review progress and manage deadlines effectively.
- Ensured adherence to guidelines during the evaluation of materials submitted.
- Assisted in training new reviewers on best practices and procedures.
- Conducted thorough evaluations of content for relevance and completeness.
- Maintained organized records of reviewed documents for future reference.
- Documented all review processes including notes, observations, analyses, recommendations.
- Worked closely with management team to provide updates on progress of reviews being conducted.
- Managed case files using dispute resolution management software effectively.
- Documented case details meticulously to maintain accurate records and compliance.
- Drafted letters of explanation for customers regarding dispute resolutions.
- Reviewed and evaluated evidence, documents, and other information related to disputes.
- Maintained accurate records of all dispute cases handled.
Hospital Licensed Practical Nurse
Princeton Baptist Medical Center
Birmingham
05.2021 - 06.2023
- Administered medications and treatments as prescribed by healthcare providers.
- Assisted in patient assessments and monitored vital signs throughout shifts.
- Collaborated with nursing staff to develop and implement patient care plans.
- Educated patients and families on health management and medication instructions.
- Maintained cleanliness and safety standards in patient care areas.
- Documented patient information accurately in electronic medical record systems.
- Assisted with admissions, discharges, and transfers of patients as needed.
- Provided emotional support to patients and families during hospital stays.
- Collaborated with physicians, nurses, social workers, dietitians, therapists, and pharmacists to ensure continuity of care across multiple disciplines.
- Maintained accurate records of patient progress notes, treatments, medications, and test results.
- Conducted discharge planning for discharged patients by coordinating with other healthcare team members.
- Developed individualized care plans for each assigned patient based on assessment findings.
- Ensured that all clinical practices were performed within scope of practice guidelines set forth by governing bodies.
- Educated patients on self-care techniques and health maintenance strategies.
- Administered diagnostic tests accurately following established protocols.
- Provided emotional support to families during difficult times related to their loved one's illness or hospitalization.
- Assessed patients' conditions and monitored vital signs.
- Communicated effectively with other healthcare professionals regarding changes in patient status or plan of care updates.
- Managed medication administration including recording, dosage calculations, and disposing of unused drugs.
- Identified potential safety risks for patients and implemented appropriate interventions.
- Instructed family members regarding proper post-discharge home care activities.
- Performed various treatments, such as wound dressing changes and catheterizations.
- Assisted physicians in medical procedures such as inserting IVs or administering injections.
- Maintained a clean and safe environment for both staff members and patients.
- Administered medications as prescribed by physicians in accordance with established policies and procedures.
- Monitored patient responses to treatments and reported any changes or concerns promptly to the doctor or nurse manager.
- Supervised nursing assistants in providing quality care to patients.
- Administered medications and therapies in accordance with physicians orders.
- Charted changes in patient conditions and discussed concerns with supervising healthcare provider.
- Answered patient calls, identified issues, and determined how best to provide assistance within parameters established by facility and supervisor.
- Addressed patient care needs, collected vitals, dressed wounds, and managed catheters.
- Guaranteed exceptional care quality by correctly administering medication, inserting and caring for catheters, dressing and changing wounds and assisting with personal hygiene.
- Observed strict confidentiality and safeguarded all patient-related information.
- Communicated with patients with compassion while keeping medical information private.
- Answered patients' calls to determine how to assist.
- Assembled and used catheters, tracheotomy tubes or oxygen suppliers.
- Communicated effectively with patients and loved ones to explain diagnoses, treatment options and procedures.
- Worked with social workers, physical therapists and speech therapists to assess patient needs, plan and adjust plans of care and actualize nursing interventions to promote and restore patient health.
- Prepared patients for examinations, tests or treatments and explained procedures.
- Delivered high-quality direct and indirect nursing care to patients.
- Provided behavioral and emotional support and closely supervised patients suffering from dementia and Alzheimer's.
- Collaborated with multi-disciplinary staff to improve overall patient care and response times.
- Evaluated nursing intervention outcomes by conferring with other healthcare team members.
- Provided pre- and post-operative nursing care.
- Collected biological samples for routine laboratory testing to assist diagnostic processes.
- Prepared or examined food trays for conformance to prescribed diet.
Home Health Licensed Practical Nurse
Kindred at Home
Jasper
04.2018 - 06.2023
- Administered medications and treatments to patients in home settings.
- Monitored patient vital signs and reported changes to healthcare team.
- Assisted patients with daily living activities and personal care.
- Educated patients and families on health management and safety practices.
- Collaborated with interdisciplinary teams to develop care plans for patients.
- Documented patient progress and maintained accurate medical records.
- Provided emotional support to patients and families during care visits.
- Ensured compliance with safety regulations and infection control protocols.
- Maintained a safe environment for all patients by adhering to infection control policies and procedures.
- Collaborated with other healthcare professionals to coordinate optimal patient care plans.
- Educated patients on disease prevention and health maintenance strategies.
- Assessed patient's condition by observing physical and mental status, measuring vital signs, and reviewing medical records.
- Implemented infection control protocols within the home environment to maintain safety standards.
- Managed multiple tasks simultaneously while providing quality service to meet deadlines.
- Instructed patients and family members about proper home healthcare techniques such as bandaging, administering injections, using assistive devices.
- Monitored patient progress toward goals set in the plan of care, adjusting as needed.
- Administered medications and treatments as prescribed by physicians or authorized nurse practitioners.
- Developed individualized treatment plans for each patient based on assessment of needs.
- Performed a variety of laboratory tests such as urinalysis, glucose monitoring, and blood pressure readings.
- Ensured that all documentation was accurate and up-to-date regarding patient assessments and interventions provided.
- Provided direct nursing care to patients in their homes, including wound care and medication administration.
- Consulted with physicians regarding orders for diagnostic tests or treatments related to specific diagnoses.
- Reported changes in patients' conditions to primary care providers or other specialists as required.
- Participated in case conferences with interdisciplinary team members to discuss treatment plan updates or modifications.
- Evaluated effectiveness of nursing interventions through ongoing assessment of patient responses.
- Utilized computer software programs for record keeping purposes such as tracking data trends or documenting clinical notes.
- Maintained communication with families regarding patient progress or any changes in condition observed during visits.
- Educated patients on health maintenance techniques such as proper nutrition and hygiene practices.
- Completed initial assessments of patients and family to determine and address individual home care needs.
- Assisted patients with activities of daily living and functional mobility to increase comfort and quality of life.
- Charted changes in patient conditions and discussed concerns with supervising healthcare provider.
- Answered patient calls, identified issues, and determined how best to provide assistance within parameters established by facility and supervisor.
- Assisted with client personal care needs to foster independence and well-being.
- Addressed patient care needs, collected vitals, dressed wounds, and managed catheters.
- Conducted regular re-evaluations to address changes in needs and conditions, and introduced revisions to care plans.
- Participated in on-call rotations and delivered after-hours care.
- Supported patients with activities of daily living and functional mobility to improve comfort and quality of life and reduce pain.
- Administered prescribed medications and started intravenous fluids to address patient symptoms and underlying etiologies.
- Collected biological samples for routine laboratory testing to assist diagnostic processes.
- Assessed patient conditions during in-home visits, developing personalized care plans.
- Utilized electronic health records to document patient care accurately and comprehensively.
- Conducted telehealth visits, providing remote support and monitoring.
- Provided wound care, including dressing changes and monitoring for signs of infection.
- Coordinated medical equipment rentals and installations for home use.
- Trained new home health nurses, sharing best practices and clinical expertise.
- Delivered compassionate end-of-life care, supporting patients and families emotionally.
- Supported patients with chronic illness management, optimizing quality of life.
- Managed the administration of intravenous (IV) therapies and nutrition.
- Administered medications and therapies in accordance with physicians orders.
- Took temperatures or blood pressures, dressed wounds and provided other basic patient care or treatments.
- Documented patient medical histories, current symptoms and vitals.
- Guaranteed exceptional care quality by correctly administering medication, inserting and caring for catheters, dressing and changing wounds and assisting with personal hygiene.
Respiratory Licensed Practical Nurse
Health Care Solutions
Jasper
04.2016 - 04.2018
- Provided direct patient care and monitored vital signs in diverse medical settings.
- Administered medications and treatments as prescribed by healthcare providers.
- Assisted in developing and implementing patient care plans with interdisciplinary teams.
- Educated patients and families on health maintenance and disease prevention strategies.
- Maintained accurate patient records and documentation using electronic health systems.
- Supported infection control practices to ensure a safe environment for patients and staff.
- Responded promptly to patient needs, demonstrating empathy and effective communication skills.
- Administered medications and treatments according to established protocols.
- Performed physical assessments, including vital signs and health history documentation.
- Maintained a safe environment by following infection control policies and procedures.
- Communicated effectively with patients, family members, healthcare team members, and other stakeholders regarding patient care plans or concerns.
- Educated patients on disease prevention and management strategies for their individual conditions.
- Monitored patient's respiration activity, blood pressure and blood glucose levels in response to medical administration.
- Ensured that all clinical documentation is accurate and up-to-date in the electronic medical record system.
- Provided emotional support to patients dealing with illness or injury related issues.
- Looked for physical, emotional, and symptomatic changes in patient condition and obtained necessary care for medical concerns.
- Promoted culture of safety for patients and employees through proper identification, reporting documentation and prevention.
- Assessed patient complaints accurately and provided appropriate interventions.
- Coordinated scheduling of follow-up appointments with primary care providers.
- Used sterile techniques to prepare patients for procedures.
- Followed rehabilitation and treatment care plans to accelerate patient recovery, minimize pain, and optimize patient outcomes.
- Facilitated referrals for specialty services when necessary.
- Assisted in the development and implementation of nursing policies and procedures.
- Charted changes in patient conditions and discussed concerns with supervising healthcare provider.
- Delivered high-quality direct and indirect nursing care to patients.
Clinic Licensed Practical Nurse
UAB Student Health
Birmingham
05.2011 - 04.2016
- Administered medications and treatments per physician orders for patient care.
- Monitored vital signs and reported changes to the healthcare team.
- Assisted in patient assessments and developed care plans with nursing staff.
- Educated patients on health management and wellness strategies during consultations.
- Collaborated with multidisciplinary teams to ensure comprehensive patient care.
- Maintained accurate patient records using electronic health record systems.
- Supported new staff through training on clinic protocols and procedures.
- Ensured compliance with safety regulations and infection control standards in the clinic.
- Assessed patient needs and developed individualized care plans to meet those needs.
- Collaborated with physicians and other healthcare professionals in developing individualized treatment plans for each patient's needs.
- Provided education to patients regarding disease prevention, medication management and health promotion.
- Assisted with scheduling tests and procedures through outside providers if required.
- Maintained accurate documentation of patient records, including assessment results, treatments provided and progress notes.
- Monitored patients' response to treatments and reported any changes to physician or nurse practitioner.
- Administered immunizations according to established protocols.
- Educated patients on proper self-care techniques for chronic conditions such as diabetes mellitus or hypertension.
- Acted as a liaison between the clinic and external agencies when needed.
- Evaluated effectiveness of treatments by monitoring patient progress toward desired outcomes.
- Assisted medical staff with diagnostic tests such as X-rays or laboratory work.
- Scheduled appointments for patients utilizing an electronic medical record system.
- Conducted follow up calls after a procedure or hospitalization to assess recovery status.
- Performed nursing procedures such as wound care, administering medications and injections, and assisting with physical examinations.
- Provided guidance on diet modifications based on physician orders.
- Prepared patient rooms for visits by cleaning, sanitizing equipment and stocking supplies.
- Coordinated timely refills for patients' prescriptions by obtaining authorizations and transmitting paperwork.
- Collected blood samples using phlebotomy best practices and labeled specimens for testing.
- Performed nursing assessments and collected patient medical histories to help determine proper diagnosis.
- Took temperatures or blood pressures, dressed wounds and provided other basic patient care or treatments.
- Observed strict confidentiality and safeguarded all patient-related information.
- Communicated with patients with compassion while keeping medical information private.
- Answered patients' calls to determine how to assist.
- Measured and recorded patient height, weight and other vital signs.
- Collected blood, urine or sputum from patients to perform routine laboratory tests.
- Assembled and used catheters, tracheotomy tubes or oxygen suppliers.
- Educated clients, patients and caregivers on medical diagnoses, treatment options, chronic disease self-management and wound management.
- Worked with social workers, physical therapists and speech therapists to assess patient needs, plan and adjust plans of care and actualize nursing interventions to promote and restore patient health.
- Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
Cardiology Research Licensed Practical Nurse
UAB Cardiology
Birmingham
02.2011 - 05.2011
- Documented patient information accurately in electronic health record systems.
- Maintained a clean and safe environment in accordance with health standards.
- Observed changes in patient's condition and reported any significant changes to the registered nurse or physician.
- Performed physical assessments, including vital signs and health history documentation.
- Monitored vital signs, fluid intake and output levels, glucose levels, and other medical tests results.
- Maintained a safe environment by following infection control policies and procedures.
- Communicated effectively with patients, family members, healthcare team members, and other stakeholders regarding patient care plans or concerns.
- Conducted regular rounds to assess the status of assigned patients.
- Monitored patient's respiration activity, blood pressure and blood glucose levels in response to medical administration.
- Collected and documented vital signs to track current patient conditions.
- Adhered to facility policies and procedures while providing quality nursing care.
- Ensured that all clinical documentation is accurate and up-to-date in the electronic medical record system.
Rehabilitation Nurse
Ridgeview Health Services
Birmingham
12.2005 - 05.2011
- Provided patient education on rehabilitation techniques and care plans.
- Assisted patients with daily living activities and mobility exercises.
- Coordinated with interdisciplinary teams to develop individualized treatment plans.
- Monitored patient progress and adjusted care strategies as needed.
- Documented patient assessments and interventions in electronic health records.
- Trained nursing staff on rehabilitation practices and safety protocols.
- Advocated for patient needs during care team meetings and consultations.
- Ensured compliance with healthcare regulations and quality standards in treatment delivery.
- Developed patient discharge plans in collaboration with the interdisciplinary team.
- Assisted in developing departmental goals related to quality assurance initiatives.
- Collaborated with interdisciplinary team members to ensure best possible outcomes for patients.
- Provided emotional support to patients dealing with long-term disabilities or chronic illnesses.
- Actively sought opportunities to mentor new rehab nurses entering the field.
- Initiated referrals for additional services such as home health or hospice when necessary.
- Assessed patient physical, psychological and social needs to develop individualized care plans.
- Performed wound care management, including dressing changes, debridement and irrigation.
- Attended continuing education classes and workshops relevant to current trends in rehabilitation nursing.
- Maintained accurate records of nursing assessments, interventions, evaluations and progress notes.
- Monitored vital signs, neurological function and pain levels of patients during treatment sessions.
- Conducted regular follow-up visits to evaluate effectiveness of treatments and modify as needed.
- Administered medications as prescribed by physicians according to hospital policies and procedures.
- Demonstrated knowledge of rehabilitation techniques such as exercise programs, therapeutic modalities and adaptive equipment use.
- Evaluated patient's response to rehabilitative treatments while providing encouragement throughout recovery process.
- Provided patient education on disease processes, treatments and self-management strategies.
- Implemented evidence based practice guidelines into daily nursing practice.
- Facilitated communication between patient families and other healthcare providers regarding care plan development.
- Educated staff nurses on rehabilitation principles, protocols and practices.
- Administered oral, IV and intra-muscular medications and monitored patient reactions.
- Responded to emergency situations with speed, expertise and level-headed approaches to provide optimal care, support and life-saving interventions.
- Observed strict safety measures, including checking medication dosages before administration to patients.
- Advocated for patient needs with interdisciplinary team and implemented outlined treatment plans.
- Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
- Monitored diet, physical activity, behaviors, and other patient factors to assess conditions and adjust treatment plans.
- Interpreted and evaluated diagnostic tests to identify and assess patient's condition.
- Prepared medical equipment and tools to aid physician during examination and treatment of patients.
- Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
- Stocked clinical workstations and procedure rooms with necessary supplies.
- Collaborated with health groups to plan or implement programs designed to improve overall health of communities.
- Conducted specified laboratory tests to help detect conditions and determine diagnosis.
Education
Licensed Practical Nurse - Nursing
Bevill State Community College
Sumiton, AL12-2005
Skills
- document review
- compliance evaluation
- case documentation
- digital tracking tools
- process improvement
- dispute resolution
- team collaboration
- quality assurance
- patient care strategies
- healthcare documentation
- constructive feedback
- emotional support
- care plan development
- effective communication
- time management
- Proofreading
- Research and interviews
- Attention to detail
- Multitasking Abilities
- Deadline attainment
- Quality assessment
- Script and scenario design
- Editing proficiency
- Team contribution
- Editing and review
- Excellent interpersonal communications
- Information gathering
- Active listening
- Time management abilities
- Task prioritization
- Grammar skills
References
References available upon request.
Timeline
Dispute Resolution Reviewer
J29
06.2023 - Current
Hospital Licensed Practical Nurse
Princeton Baptist Medical Center
05.2021 - 06.2023
Home Health Licensed Practical Nurse
Kindred at Home
04.2018 - 06.2023
Respiratory Licensed Practical Nurse
Health Care Solutions
04.2016 - 04.2018
Clinic Licensed Practical Nurse
UAB Student Health
05.2011 - 04.2016
Cardiology Research Licensed Practical Nurse
UAB Cardiology
02.2011 - 05.2011
Rehabilitation Nurse
Ridgeview Health Services
12.2005 - 05.2011
Licensed Practical Nurse - Nursing
Bevill State Community College