Kimberly Kaiser
Fairfax,MN
Summary
Experienced and detail-oriented Registered Nurse with a strong background in long-term care insurance assessments, benefit eligibility reviews, and interdisciplinary collaboration. Skilled in documentation and review of underwriting and benefit eligibility assessments in compliance with insurance company policies and regulatory standards. Demonstrates strong clinical judgment, critical thinking, and evidence-based decision-making to determine coverage eligibility. Recognized as a quick learner with the ability to adapt to new systems and processes. Effective communicator with members, providers, and internal teams, committed to delivering coordinated, quality service and fostering a connected care experience where every member feels valued.
Overview
25
25
years of professional experience
Work History
Registered Nurse Clinical Claims Trainer
illumifin (formerly LTCG)
Woodbury, MN
01.2022 - Current
- Designed and executed comprehensive onboarding and training programs for newly hired registered nurses and social workers entering care coordinator roles.
- Designed and delivered targeted education and training programs for a network of 1,800 contract nurses performing underwriting and benefit eligibility assessments for long-term care insurance, ensuring consistency in clinical evaluation standards, regulatory compliance, and documentation accuracy.
- Conducted quality assurance checks to ensure accuracy, compliance, and consistency in clinical documentation and assessment processes, contributing to improved service delivery and adherence to regulatory standards.
- Developed and facilitated a leadership development program focused on strategic thinking, team management, and communication skills for emerging healthcare leaders.
- Proficient in navigating and documenting across multiple computer systems, ensuring continuity, accuracy, and efficiency in cross-platform workflows.
- Supports team initiatives by mentoring new staff, sharing best practices, and fostering open communication.
- Contributed to a culture of accountability and shared success by actively participating in team huddles, feedback sessions, and collaborative problem-solving.
- Partnered with cross-functional departments (underwriting, claims, training) to streamline workflows and improve service delivery.
Clinical Claims Care Coordinator
LTCG (currently illumifin)
Woodbury, MN
09.2012 - 01.2022
- Conduct quality reviews of benefit eligibility assessments for long-term care insurance claims, ensuring accuracy, compliance, and adherence to clinical and contractual standards.
- Perform telephone-based assessments with clients, family members, and care providers to determine benefit eligibility, demonstrating empathy, clarity, and clinical judgment.
- Chosen as part of exclusive team to execute specialized telephone assessments during COVID-19 pandemic for high-profile client with elevated documentation and quality standards.
- Cross-trained in both underwriting and claims departments, enhancing operational flexibility and fostering a deeper understanding of long-term care insurance workflows and interdepartmental collaboration.
Registered Nurse, Telephonic Interviewer
Univita Health/LTCG (currently illumifin)
Woodbury, MN
09.2005 - 09.2012
- Conducted telephonic health assessment interviews with insurance applicants nationwide, gathering clinical data to support underwriting decisions and ensure eligibility for long-term care coverage.
- Administered the Mental Competency Assessment Screening (MCAS) to evaluate cognitive function and decision-making capacity in clients undergoing long-term care insurance evaluations.
- Delivered high-quality customer service by addressing client needs with professionalism, empathy, and efficiency.
Registered Nurse, Telephonic Interviewer
Nation's CareLink (currently illumifin)
Woodbury, Minnesota
12.2002 - 03.2004
- Conducted telephonic health assessment interviews with insurance applicants nationwide, gathering clinical data to support underwriting decisions and ensure eligibility for long-term care coverage.
- Administered the Mental Competency Assessment Screening (MCAS) to evaluate cognitive function and decision-making capacity in clients undergoing long-term care insurance evaluations.
- Delivered high-quality customer service by addressing client needs with professionalism, empathy, and efficiency.
Registered Nurse, Float Pool
Regions Hospital
St. Paul, MN
05.2001 - 11.2002
- Provided direct patient care across diverse departments and units.
- Conducted comprehensive assessments to identify patient needs and conditions.
- Utilized electronic health records for documentation and communication purposes.
- Demonstrated excellent communication skills when interacting with patients, families and healthcare team members.
- Collaborated with interdisciplinary teams to coordinate patient treatment plans.
Education
Bachelor of Science - Nursing
Minnesota State University, Mankato
Mankato, MN12-2000
Skills
- Benefit Eligibility Assessments (Telephonic & Documentation-Based)
- Case Review & Documentation
- Cognitive Screening (MMSE, MCAS)
- Clinical Judgment & Evidence-Based Decision Making
- Quality Assurance & Compliance Auditing
- Long-Term Care Insurance Evaluation
- Cross-Training in Underwriting & Claims Processes
- Interdisciplinary Team Collaboration
- Committed to Shared Goals & Collective Success
- Leadership Program Development & Facilitation
- Training & Education for Clinical Staff
- Customer Service Excellence
- Remote Work Efficiency & Autonomy
- Multi-system navigation and documentation
- Microsoft Office Suite (Word, Excel, Outlook, PowerPoint)
- Microsoft Teams
- Zoom
- Adobe Acrobat
- Google Workspace
- SharePoint
- Articulate 360
Accomplishments
Innovation Accountability Compassion Trust (IACT) Award Winner, Q4 2011
Timeline
Registered Nurse Clinical Claims Trainer
illumifin (formerly LTCG)
01.2022 - Current
Clinical Claims Care Coordinator
LTCG (currently illumifin)
09.2012 - 01.2022
Registered Nurse, Telephonic Interviewer
Univita Health/LTCG (currently illumifin)
09.2005 - 09.2012
Registered Nurse, Telephonic Interviewer
Nation's CareLink (currently illumifin)
12.2002 - 03.2004
Registered Nurse, Float Pool
Regions Hospital
05.2001 - 11.2002
Bachelor of Science - Nursing
Minnesota State University, Mankato