Summary
Overview
Work History
Education
Skills
Affiliations
Accomplishments
Certification
Timeline
Generic

Kristi Huskey

Manchester,TN

Summary

Dynamic UM Clinical Reviewer Senior Analyst at EviCore by Evernorth, skilled in clinical review and regulatory compliance. Proven ability to enhance communication between providers and payers, while developing educational materials. Recognized for meticulous documentation accuracy and strong problem-solving skills, fostering collaboration among healthcare professionals to drive effective outcomes.

Overview

9
9
years of professional experience
1
1
Certification

Work History

UM Clinical Reviewer Senior Analyst

EviCore by Evernorth
Franklin, TN
03.2016 - Current
  • Facilitated communication between providers and payers regarding denials or issues identified during the review process.
  • Conducted clinical reviews of medical records to ensure compliance with regulatory requirements.
  • Adhered to all HIPAA regulations when handling confidential patient information.
  • Developed educational materials on topics related to clinical reviews.
  • Worked closely with physicians, nurses, pharmacists, social workers, and other healthcare professionals as needed.
  • Proofread documents carefully to check accuracy and completeness of all paperwork.
  • Assessed programs to identify risks or problems to determine appropriate responses.
  • Maintained library of model documents, templates or other reusable knowledge assets.
  • Identified needs of customers promptly and efficiently.
  • Maintained updated knowledge base on industry trends and best practices.
  • Maintained positive working relationship with fellow staff and management.
  • Transmitted information or documents to customers through email, mailings or facsimile machine.
  • Answered questions and fulfilled requests with friendly and knowledgeable service.

Education

Bachelor of Science - Nursing

Western Governors University
Salt Lake City, UT
02-2022

Skills

  • Clinical review
  • Regulatory compliance
  • HIPAA compliance
  • Medical record analysis
  • Risk assessment
  • Documentation accuracy
  • Effective communication
  • Multitasking Abilities
  • Professionalism
  • Analytical skills
  • Customer service
  • Team collaboration
  • Educational material development
  • Problem solving
  • Industry knowledge
  • Detail-oriented

Affiliations

I have participated in PSU's call out project and creation of educational power points for team meetings.

I work to uplift my co workers through our Standout program and Monthly Team Recognition.

I participate in and have led our companies Wellness Challenge.

I serve a regular role as a Physician Support Units team Chat Monitor.

I enjoy participating in Company promoted and non company associated Volunteer events, such as Girls on the Run program and my Local Community Rescue Squad.

Accomplishments

  • I have received numerous emails of appreciation, comments on the quality of work I provide and notations of the help I've been able to navigate and provide to clients with challenging questions or concerns.

Certification

  • RN, BSN

Timeline

UM Clinical Reviewer Senior Analyst

EviCore by Evernorth
03.2016 - Current

Bachelor of Science - Nursing

Western Governors University

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