Melissa Freeman
Utilization Review Manager
Gardner,KS
Summary
Reliable and goal-oriented management professional committed to patient benefit. Dedicated team player with knowledge of medical and psychiatric care. Documented strengths in time management, mentoring, and multi-tasking.
Overview
13
13
years of professional experience
6
6
years of post-secondary education
Work History
Utilization Review Manager
Cottonwood Springs
Olathe, KS
04.2019 - Current
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Obtained authorizations from multiple insurance carriers for various levels of care including inpatient mental health, detoxification, partial hospitalization, and intensive outpatient.
- Supervised and maintained all utilization review documentation through Medik.
- Directed training and retraining of employees to boost performance and enhance business results.
- Managed denials and appeals for hospital. Completed follow up with insurance providers for outcomes.
Utilization Review Specialist
Cottonwood Springs
Olathe, KS
07.2017 - 04.2019
- Performed prior authorization review of services requiring notification.
- Obtained concurrent authorizations from multiple insurance carriers for various levels of care.
- Collaborated with treatment team, including physicians, nursing staff, therapists, and administration, for collaboration and patient benefit.
Intake Therapist
Cottonwood Springs
Olathe, KS
10.2015 - 07.2017
- Completed phone screenings for potential patients. Provided education on provided levels of care.
- Completed initial assessments for patients interested in inpatient treatment, PHP, and IOP levels of care. Collaborated with treatment team for treatment recommendation.
- Crisis counseled individuals and families to bring awareness of concerns and develop action plans.
Emergency Screening Specialist
Bert Nash Community Mental Health Center
Lawrence, KS
12.2014 - 10.2015
- Completed emergency screens for clients in crisis. Directed process for hospitalization as needed.
- Provided crisis counseling and intervention.
- Assisted with Center client intakes to establish services.
Unit Secretary
Olathe Medical Center
Olathe, KS
06.2009 - 12.2014
- Organized paperwork such as charts and unit information for hospital and patient needs. Organized patient files and streamlined operations to improve efficiency.
- Answered telephone calls to offer hospital information, answer questions, and direct calls to staff.
- Transcribed doctors' medication orders, lab test requests, and care plans.
- Maintained rapport with physicians, nurses, and other healthcare personnel.
Education
Master of Arts - Counseling
MidAmerica Nazarene University
06.2012 - 05.2014
Bachelor of Arts - Psychology
University of Kansas
08.2008 - 05.2012
Skills
Pre-Certifications and Concurrent Reviews
Multidisciplinary Team Collaboration
Documentation and Reporting
Appeals Management
Additional Information
- Licensed Professional Counselor, Kansas
- National Certified Counselor
Timeline
Utilization Review Manager
Cottonwood Springs
04.2019 - Current
Utilization Review Specialist
Cottonwood Springs
07.2017 - 04.2019
Intake Therapist
Cottonwood Springs
10.2015 - 07.2017
Emergency Screening Specialist
Bert Nash Community Mental Health Center
12.2014 - 10.2015
Master of Arts - Counseling
MidAmerica Nazarene University
06.2012 - 05.2014
Unit Secretary
Olathe Medical Center
06.2009 - 12.2014
Bachelor of Arts - Psychology
University of Kansas
08.2008 - 05.2012