Mary Jordan
Lake View,SC
Summary
Highly organized Appeals Coordinator with a background in managing complex appeals processes across diverse healthcare settings. Possess strong communication skills for liaising between patients, healthcare providers, and insurance companies. Known for ability to interpret medical policies and regulations while maintaining compliance and patient satisfaction. Demonstrated history of successfully resolving disputes and reducing claim denials.
Overview
10
10
years of professional experience
Work History
Appeals Coordinator
McLeod Heath
Florence, SC
10.2024 - Current
- Investigated appeals to determine validity of claims and established appropriate action plans.
- Resolved appeals through negotiations with insurance companies, attorneys, and other parties.
- Evaluated medical records to ensure accuracy of diagnoses and treatments.
- Provided support to internal personnel regarding appeals process inquiries.
- Reviewed denied claims for potential resubmission or reconsideration.
- Responded promptly to all correspondence from third-party payers regarding patient claims.
Staff Nurse
McLeod Health
Florence, SC
03.2015 - 10.2020
- Maintained accurate records of patient progress notes, medications administered and other relevant data.
- Developed individualized teaching strategies for each patient based on their specific needs.
- Assisted physicians with exams, lab tests or other procedures as requested.
- Identified potential problems or issues that may arise during treatment, such as drug interactions or allergies, and provided appropriate interventions when necessary.
- Demonstrated effective communication skills while interacting with patients, families, physicians and other healthcare staff members.
- Actively participated in departmental meetings, training sessions and educational seminars.
- Utilized an electronic medical record system to store patient information securely.
- Managed multiple tasks simultaneously while maintaining quality standards of care.
Education
Licensed Practical Nurse - Nursing
Marion County School of Practical Nursing
Marion05-1994
Skills
- Confidentiality
- Effective communication abilities
- Organizational abilities
- Problem-solving capabilities
- Conflict Resolution
- Training development
- Problem-solving aptitude
- Attention to Detail
- Professionalism
- Team Collaboration
- Problem-solving abilities
- Professional Demeanor
- Adaptability
- Organizational Skills
Timeline
Appeals Coordinator
McLeod Heath
10.2024 - Current
Staff Nurse
McLeod Health
03.2015 - 10.2020
Licensed Practical Nurse - Nursing
Marion County School of Practical Nursing
Similar Profiles
Korina Banks, DNP, RNKorina Banks, DNP, RN
CLINICAL NURSE EDUCATOR at McLeod Heath/ Mcleod Physician AssociatesCLINICAL NURSE EDUCATOR at McLeod Heath/ Mcleod Physician Associates
BENJAMIN IVEYBENJAMIN IVEY
Patient Access Representative at McLeod HeathPatient Access Representative at McLeod Heath
Eva RzucidloEva Rzucidlo
Director and Chief of Vascular Surgery at McLeod Regional Medical Center, Mcleod Vascular AsDirector and Chief of Vascular Surgery at McLeod Regional Medical Center, Mcleod Vascular As
Valerie TurnerValerie Turner
Special Education Teacher at Dillon District FourSpecial Education Teacher at Dillon District Four
Jonathan Anthony PriceJonathan Anthony Price
Landscaping Manager at Self-employeedLandscaping Manager at Self-employeed