Kimberly Buckingham
Enfield,CT
Summary
Seasoned Clinical Review DME Supervisor with a proven track record at CareCentrix, adept in medical claim analysis and fostering staff development. Excelled in enhancing patient care through effective operations management and process improvement. Skilled in Epic systems and conflict resolution, consistently achieving project goals and improving team performance.
Overview
21
21
years of professional experience
1
1
Certification
1
1
year of post-secondary education
Work History
Clinical Review DME Supervisor
CareCentrix
Hartford, USA
12.2021 - 07.2024
- Conducted independent assessments of medical records to determine outcomes for complex and catastrophic cases.
- Fostered a positive and motivating work environment, leading to an increase in team morale.
- Directed and supervised a team of 19 nurses in daily operations.
- Created new strategies for improving customer service standards within the organization.
- Set specific goals for projects to measure progress and evaluate end results.
- Facilitated training sessions for new employees on company policies and procedures.
- Analyzed key performance indicators to identify effective strategies.
- Organized client meetings to provide project updates.
- Conducted weekly meetings with team members to discuss upcoming tasks and project deadlines.
- Trained new employees on company policies and procedures.
- Recruited, hired, trained, mentored, coached, evaluated, and terminated staff as necessary.
- Conducted regular performance evaluations, providing constructive feedback and setting individual goals.
- Coordinated with other department supervisors to ensure smooth workflow and project alignment.
- Monitored employee attendance, addressing any punctuality or absenteeism issues.
- Collaborated with other departments to coordinate workflow processes between teams.
Nurse Unit Manager
JGS Lifecare
Longmeadow , MA
05.2018 - 04.2021
- Worked with diverse staff to enhance patient care and speed of response.
- Defined performance benchmarks aligned with company objectives.
- Coordinated staff meetings to review policies and procedures.
- Resolved customer complaints to uphold service standards.
- Conducted regular performance evaluations, offering constructive feedback and setting goals.
- Built work schedules and staff assignments, taking workload, space, and equipment availability into consideration.
- Managed a team of 45 nurses, and CNA's, fostering a collaborative and productive work environment.
- Collaborated in ACO meetings to minimize risk of patient readmissions.
- Administered successful placement of high-risk patients in essential health programs.
- Established solid relations with leadership and staff by attending board meetings and coordinating interdepartmental information exchanges.
Care Coordinator, LPN
FLMA
Hartford, USA
10.2016 - 12.2016
- Completed provider insurance & employer forms required for patients to receive leave of absence and medically necessary surgery
- Analyzed claims activity and prepared reports for clients/carriers and management as needed
- Verified on-going disability and participated in claim reviews with specialized resources including nurses, physicians, vocational rehabilitation, etc
- To discuss return to work opportunities as appropriate
- Communicated with claimants, employers, and various medical professionals to gather information regarding eligibility, benefit authorization, and ongoing management of STD or LTD benefits
- Ensured a timely and appropriately coordinated transition of claims from STD to LTD, providing a well-managed and seamless claims experience to claimants
- Trained Medical Assistants in asepsis and taking proper vital signs, set up in office procedures and assisted as needed
- Established rapport for nursing excellence, excelling as receptive team member and forging superior relationships with staff and patients
LPN Charge Nurse
Suffield House
Suffield, USA
05.2008 - 04.2010
- Administered prescribed medications or start intravenous fluids, noting times and amounts on patients' charts
- Provided basic patient care or treatments, such as taking temperatures or blood pressures, dressing wounds, treating bedsores, giving enemas, performing catheterizations
- Worked as part of a healthcare team to assess patient needs, plan and modify care, and implement interventions
LPN-Sub-acute Charge Nurse
Haven Health Care
South Windsor, USA
02.2003 - 05.2008
- Monitored and evaluated medical conditions of patients in collaboration with other health care professionals
- Developed and assisted others in the development of care and treatment plans
- Supervised nurses' aides/ CNA's
- Recorded food and fluid intake and output
- Evaluated nursing intervention outcomes, conferring with other healthcare team members as necessary
- Provided basic patient care or treatments, such as taking temperatures or blood pressures, dressing wounds, treating bedsores
- Coordinated orthopedic appointments of sub acute patients
- Performed PROM exercises
Education
GOODWIN COLLEGE -
GOODWIN COLLEGE
East Hartford, CT01.2014
Associate of Science - Licensed Practical Nurse
NEW ENGLAND TECHNICAL INSTITUTE
New Britain, CT01.2003
Associate of Science - Nursing
ASNUNTUCK COMMUNITY COLLEGE
Enfield, CT 07.2024 - Current
Skills
- Triage
- Medical claim analysis skills
- BLS Certified
- Medication Administration
- ERISA
- ICD-10
- Knowledge of ERISA regulations
- Excellent written and verbal communication skills
- Able to prioritize and perform multiple tasks
- ICD-9
- Ability to navigate Meditech System
- Ability to multitask
- Excellent MS Office/ Word and Excel skills
- Medical Records
- Excellent written
- EMR Systems
- Epic
- Excel
- Documentation review
- Vital Signs
- Excellent follow through skills
- Nursing
- Experience Administering Injections
- Insurance Verification
- Ability to effectively communicate claim decisions
- Epic Credentialed
- Ability to analyze data, applying criteria and guidelines
- Patient Care
- Analysis Skills
- Schedule development
- Conflict resolution
- Staff development
- Training and mentoring
- Process improvement
- Operations management
- Performance management
- Expectation setting
Certification
- BLS Certification
- LPN License in CT & MA
- Epic Certification
- PCC literate
Affiliations
- Volunteer disability advocacy work
- Attend IEP and 504 meetings
- Attend Wright's Law Conventions, improving my advocacy skills
Accomplishments
- Supervised a team of 18 staff members.
- Improved KPI and quality expectations meeting all SLR's under my supervision.
Timeline
Associate of Science - Nursing
ASNUNTUCK COMMUNITY COLLEGE
07.2024 - Current
Clinical Review DME Supervisor
CareCentrix
12.2021 - 07.2024
Nurse Unit Manager
JGS Lifecare
05.2018 - 04.2021
Care Coordinator, LPN
FLMA
10.2016 - 12.2016
LPN Charge Nurse
Suffield House
05.2008 - 04.2010
LPN-Sub-acute Charge Nurse
Haven Health Care
02.2003 - 05.2008
- BLS Certification
- LPN
- Epic Certification
- CNA
GOODWIN COLLEGE -
GOODWIN COLLEGE
Associate of Science - Licensed Practical Nurse
NEW ENGLAND TECHNICAL INSTITUTE
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