Kristen Velotta
Chesterland,OH
Summary
Experienced nurse reviewer specializing in clinical documentation, HIPAA compliance, and interdisciplinary collaboration. Proven ability to conduct thorough case reviews and enhance patient care outcomes.
Overview
18
18
years of professional experience
Work History
Acute & Post Acute Nurse Reviewer II
Medical Mutual
Brooklyn , OH
08.2021 - Current
- Conducted comprehensive clinical documentation reviews to ensure accuracy and compliance with regulatory standards.
- Performed quality assurance audits to verify adherence to organizational protocols and best practices.
- Collaborated with interdisciplinary teams to develop care plans tailored to individual patient needs.
- Facilitated case management support by coordinating resources and services for patients.
- Verified compliance with HIPAA regulations to maintain patient confidentiality and data integrity.
- Documented case reviews meticulously to support decision-making and maintain accurate records.
- Participated in training sessions to enhance knowledge of clinical standards and insurance policies.
- Utilized critical thinking skills to assess complex cases and provide informed recommendations.
- Engaged in continuous professional development to stay updated on industry changes and best practices.
- Reviewed medical claims to identify any potential coding errors or omissions.
REGISTERED NURSE, TEAM LEAD
Cleveland Clinic, Consultants in Gastroenterology
Cleveland, Ohio
03.2008 - 04.2021
- Managed daily operations of the nursing team to enhance patient care delivery.
- Coordinated patient assessments and care plans with interdisciplinary teams.
- Implemented quality assurance measures to improve patient safety protocols.
- Administer IVs and conscious sedation, and monitor patients before, during, and after procedures.
- Assists the physician with interventions, such as polyp removal, and therapeutic injection.
- Facilitated performance evaluations for nursing staff to identify training needs.
REGISTERED NURSE
Lake West Hospital
WILLOUGHBY, Ohio
07.2007 - 03.2008
- Administered medications and monitored patients for adverse reactions.
- Educated patients on health management and recovery strategies.
- Assisted in developing care plans tailored to individual patient needs.
- Conducted comprehensive health assessments to identify patient conditions.
- Collaborated with interdisciplinary teams to optimize patient care outcomes.
- Implemented infection control measures to prevent hospital-acquired infections.
- Coordinated patient discharge plans to ensure continuity of care.
- Responded promptly to emergency situations, ensuring patient safety.
- Provided compassionate support to patients and families during treatments.
- Monitored patients' vital signs and reported significant changes to physicians.
Education
Bachelor of Science - Nursing
University of Phoenix
Tempe, AZ07-2021
Associate of Applied Science - Nursing
Lakeland Community College
Willoughby, OH05-2007
Skills
- Milliman guidelines
- EMR / EHR
- Regulatory compliance
- Interdisciplinary collaboration
- Medical coding
- Critical thinking
- Effective communication
- Utilization review
- HIPAA compliance
- Clinical documentation
Timeline
Acute & Post Acute Nurse Reviewer II
Medical Mutual
08.2021 - Current
REGISTERED NURSE, TEAM LEAD
Cleveland Clinic, Consultants in Gastroenterology
03.2008 - 04.2021
REGISTERED NURSE
Lake West Hospital
07.2007 - 03.2008
Bachelor of Science - Nursing
University of Phoenix
Associate of Applied Science - Nursing
Lakeland Community College