Lyndsey Shepherd
Newark,Ohio
Summary
Dedicated Registered Nurse with 12+ years of experience in various healthcare settings including transitional care unit, inpatient hospital units, outpatient endoscopy, chronic pain management, and appeals nurse consulting. Recognized for a compassionate nature, strong work ethic, and service-oriented approach. Collaborative and multi-tasking team player with the ability to work independently. Seeking an opportunity to enhance skillsets and expand knowledge as a Capacity Management Specialist.
Overview
12
12
years of professional experience
Work History
Appeals Nurse Consultant
Aetna Insurance
08.2022 - Current
- Reviews and resolves clinical appeals
- Reviews medical records and summarizes care to ensure they align with policies and requirements
- Coordinates clinical resolution with clinician support
- Communicates and educates members regarding appeal review process
- Assists with coding combination cases using different system platforms.
Registered Nurse
Licking Memorial Hospital
06.2014 - 08.2022
- Provided patient education regarding scheduled procedures, tests, disease management/treatment, and discharge instructions
- Communicated with physicians to assess, plan, and implement changes to patient’s plan of care
- Collaborated with interdisciplinary teams to develop comprehensive treatment plans for complex patients with multiple comorbidities.
- Submited paperwork for medical clearance to appropriate providers to determine if patients can safely hold medications
- Submited prior authorizations for medication approvals and appeals if appropriate to insurance companies
- Served as a preceptor for nursing students during their clinical rotations, providing valuable real-world experience and guidance to foster professional growth.
- Assisted doctors during pain management injections and procedures.
Registered Nurse
Echo Manor
12.2012 - 05.2014
- Recorded patients thorough medical history during new patient admissions
- Recorded vitals and test results in medical records, while updating family and physician
- Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
- Sound, ethical and independent decision-making ability consistent with medical protocols
- Disciplined, energetic employee who quickly establishes rapport with patients and colleagues.
- Conducted thorough patient assessments to identify changes in condition, promptly notifying physicians and initiating appropriate interventions when necessary.
- Advised patients and caregivers of proper wound management, discharge plan objectives, safe medication use, and disease management.
Caregiver
Home Instead Senior Care
04.2012 - 01.2013
- Assisted clients with activities of daily living, promoting independence and quality of life.
- Assisted with dressing guidance, grooming, meal preparation, and medication reminders.
- Engaged patients in meaningful conversation, socialization, and activity while providing personal care assistance.
- Prioritized patient dignity, privacy, and autonomy during all aspects of care provision.
Education
Bachelors of Science in Nursing -
Ohio University
Athens, Ohio08.2016
Associate Degree of Nursing -
Central Ohio Technical College
Newark, Ohio08.2012
Skills
- Experience with medication prior authorization and monitoring compliance
- Performing appeal review and resolutions
- Proven nursing staff leadership as a charge nurse
- Experience with patient care and discharge planning
- Experience with various systems: Epic, CATS, Cotiviti, Verscend, ASD, ATV, Meditech
- Performing medical assessments and treatments
- Applied knowledge of ICD-10 and CPT codes along with assuring accurate documentation and compliance (payer and regulatory)
- Possesses strong skills in communication, organization, time management, prioritization of tasks, problem solving, and the ability to apply new skills in a timely manner
- Ability to adapt to changing policies and procedures
- Demonstrated the ability to train others on processes and workflows
Licensesandcommittees
License: Ohio, RN.386948 expires 10/2025
Former Nurse Practice Council member at Licking Memorial Hospital
Participates in Colleague Resource Groups
References
- Hailee Swisher, Ohio State University, 614-400-7121
- Tiffaney Whitten, RN, Aetna Insurance: Appeals Nurse Consultant, 515-313-6777, tiffwhitten@outlook.com
- Stacey Nugent, RN, Aetna Insurance: Appeals Nurse Consultant, 602-301-3471, snugentrn@gmail.com
Timeline
Appeals Nurse Consultant
Aetna Insurance
08.2022 - Current
Registered Nurse
Licking Memorial Hospital
06.2014 - 08.2022
Registered Nurse
Echo Manor
12.2012 - 05.2014
Caregiver
Home Instead Senior Care
04.2012 - 01.2013
Bachelors of Science in Nursing -
Ohio University
Associate Degree of Nursing -
Central Ohio Technical College
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