Lindsey Sherrill
Anderson
Summary
Detail-oriented RN Appeals Analyst with proven expertise in regulatory compliance and effective communication. Skilled in managing complex Medicare Part A appeals, ensuring accuracy and thoroughness in documentation.
Overview
14
14
years of professional experience
Work History
RN Appeals Analyst-JM Part A Appeals
Blue Cross & Blue Shield of SC
Columbia
04.2022 - Current
- Completed 5-8 appeals claims daily for Medicare part A
- Analyzed appeals cases for compliance with regulatory guidelines and policies.
- Reviewed documentation to ensure accuracy and completeness of appeal submissions.
- Collaborated with cross-functional teams to gather necessary information for appeals.
- Appeals cases included but not limited to face-to-face encounters, physician's plan of care, documentation and signature requirements and therapy requirements outlined by Medicare regulations.
Registered Nurse
Hospice of Limestone County
Athens
04.2015 - 04.2022
- Provided on-call support for patients during alternating weeks, ensuring timely response to urgent needs.
- Coordinated triage, symptom management, admissions, and assessments for 35-40 patients after hours.
Registered Nurse
Southern Care Hospice
Huntsville
04.2013 - 04.2015
- Administered medications promptly per physician orders, ensuring adherence to treatment plans.
- Delivered compassionate hospice care, enhancing patient comfort and dignity.
- Collaborated with healthcare teams to ensure patient comfort.
- Recognized signs of distress in patients and acted appropriately according to protocol.
- Supported grieving families by offering listening ear, compassion and kindness.
- Recognized signs of distress in patients and acted appropriately according to protocol.
- Developed individualized plans of care for each patient based on their specific needs.
- Collaborated with other healthcare professionals to ensure optimal quality of life for the patient.
- Supported grieving families by offering listening ear, compassion and kindness.
Registered Nurse
Athens Primary Care Associates
Athens
08.2012 - 04.2013
- Monitored patient vital signs and reported changes to the healthcare team.
- Assisted with patient education on health management and wellness practices.
- Documented patient assessments and care plans in electronic health records.
- Collaborated with physicians and staff to coordinate patient care effectively.
- Provided compassionate support to patients and families during treatment processes.
- Utilized critical thinking skills to assess clinical situations quickly and accurately.
- Collaborated with physicians, nurses, therapists, social workers and other healthcare professionals to develop individualized treatment plans for each patient.
Education
Associate of Applied Science - Nursing
Calhoun Community College
Decatur, Alabama04-2011
Skills
- Alabama RN license
Timeline
RN Appeals Analyst-JM Part A Appeals
Blue Cross & Blue Shield of SC
04.2022 - Current
Registered Nurse
Hospice of Limestone County
04.2015 - 04.2022
Registered Nurse
Southern Care Hospice
04.2013 - 04.2015
Registered Nurse
Athens Primary Care Associates
08.2012 - 04.2013
Associate of Applied Science - Nursing
Calhoun Community College