Melissa Long
Adrian,MI
Summary
Experienced medical professional with a strong background in nursing and health technology-related roles. Proficient in software system administration and technical support. Excellent written and verbal skills, attention to detail, and time management. Skilled in problem-solving and optimizing performance. Capable of managing projects and collaborating effectively with teams. Committed to continuous learning and staying current with industry trends to contribute to organizational success.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Complex Case Manager
Cigna
Adrian, MI
07.2024 - Current
- Assessed patient needs and identified appropriate resources for support services.
- Collaborate with the care team to discuss and clarify inconsistencies to ensure the accuracy of the medical record and the appropriate capture of the course of treatment provided to the patient.
- Conduct follow-up reviews of patients to offer support and identify patient discharge in a timely manner.
- Formulate physician queries to identify additional recommendations or get clarification on unclear documentation.
- Audit patient cases for accurate documentation and appropriate diagnosis.
- Working independently to review medical records of inpatient accounts for complete documentation.
- Assign an acuity and primary diagnosis to referral to ensure appropriate case management referral.
- Collaborated with healthcare providers to coordinate complex patient care plans.
- Communicated effectively with patients to explain care processes and options.
- Monitored patient progress and adjusted care plans as necessary for optimal outcomes.
- Documented case details accurately in the case management system for compliance.
- Educated patients about their conditions and available treatment options proactively.
- Monitored patients for medical changes and reviewed and revised care plans accordingly.
- Reviewed and assessed complex cases to determine the best course of action.
- Engaged in ongoing professional development activities related to case management techniques.
- Collaborated with other health professionals to ensure coordinated care plans.
Registered Nurse, LTAC
Select Medical
Ann Arbor, MI
01.2024 - 08.2024
- Document and audit patient EMR for complete and accurate charting, such as timely neuro checks, accurate restraint documentation, and real-time I&O.
- Chart information pertinent to patient outcomes to develop action plans and adjust care plans as necessary.
- Attend regular training to stay abreast of best documentation practices and revise areas that show need for improvement.
- Collaborate with case managers, nursing and other ancillary staff regarding documentation.
- Collaborated with multidisciplinary teams to develop individualized patient care plans.
- Administered medications and monitored patient responses in long-term acute care.
- Educated patients and families on health management and post-discharge care.
- Documented patient progress and updates in electronic health records accurately.
- Maintaining accurate patient records, including medical histories, test results, treatments and progress notes.
- Maintained accurate documentation of patient care services provided in accordance with hospital policies and procedures.
- Participating in interdisciplinary team meetings to discuss patient progress.
- Facilitating communication between doctors, nurses, therapists and other healthcare providers.
- Ensuring compliance with all applicable laws, regulations and standards related to the practice of nursing.
- Assessed patients, documented observations and reviewed patient charts to determine care needs.
- Implemented advanced life support techniques and interventions during emergency situations to stabilize patients.
Long-Term Care Registered Nurse
Burcham Hills Retirement Community
East Lansing, Michigan
06.2019 - 01.2024
- Analyzed clinical data to ensure completeness and integrity of records.
- Assisted in training new team members on documentation standards and tools.
- Maintained up-to-date knowledge of healthcare regulations and best practices.
- Trained new employees on the importance of providing in-depth, accurate medical records and documentation
- Identified discrepancies in documentation with providers and resolved inconsistencies in a timely manner.
- Analyzed data from multiple sources including laboratory, radiology and pathology reports.
- Participated in regular meetings with physicians, nurses, case managers, coders, therapists. to discuss changes or improvements needed for clinical documentation processes.
- Assisted physicians in development of comprehensive patient care plans through accurate coding and effective communication of results.
- Conducted patient interviews to obtain additional information for medical record entries.
- Reviewed medical records to ensure accuracy and completeness of clinical documentation.
- Reviewed all discharge summaries to ensure they meet quality standards as defined by the Joint Commission.
- Determined quality of care provided to patients through careful assessment of medical documentation.
- Acquired strong background in medical terms, illnesses and conditions and medical procedures.
- Worked with speed, efficiency and accuracy to process documentation and complete projects.
- Managed electronic health record quality assurance processes by organizing and handling requests for medical records and charts.
- Utilized copying equipment for medical record duplication, answered phones and filed documents.
Critical Care Registered Nurse
Travel Nursing Jobs
Battle Creek, Michigan
08.2023 - 12.2023
- Administered critical medications and treatments to patients in high-acuity settings.
- Monitored vital signs and reported changes to the healthcare team promptly.
- Collaborated with multidisciplinary teams to develop patient care plans.
- Educated patients and families on conditions, treatments, and discharge instructions.
- Utilized advanced monitoring equipment to assess patient status continuously.
- Documented all nursing interventions and patient responses accurately in records.
- Utilized evidence-based practice guidelines while providing nursing interventions for critically ill patients.
- Maintained accurate records of patient assessments, treatments provided, medication administration times and dosages prescribed by physicians.
- Participated in multidisciplinary rounds to discuss best practices related to critical care management.
- Assessed patients, documented observations and reviewed patient charts to determine care needs.
- Actively participated in quality improvement initiatives designed to improve outcomes for critically ill patients.
- Facilitated communication between patients, families, and healthcare professionals.
- Conducted thorough patient assessments to identify healthcare needs and potential complications.
- Engaged in professional development activities to stay current with advancements in critical care nursing.
- Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
Critical Care Registered Nurse
ProMedica
Adrian, MI
08.2022 - 08.2023
- Administered critical medications and treatments to patients in high-acuity settings.
- Accurately recorded vital signs and reported changes to the healthcare team promptly.
- Reviewed clinical documentation for accuracy and compliance with regulations.
- Participated in regular training on proper documentation practices and coding requirements.
- Analyzed clinical data to ensure completeness and integrity of records.
- Implemented process improvements to enhance documentation workflows.
- Assisted in training new team members on documentation standards and tools.
- Maintained up-to-date knowledge of healthcare regulations and best practices.
- Identified discrepancies in documentation with providers and resolved inconsistencies in a timely manner.
- Analyzed data from multiple sources including laboratory, radiology and pathology reports.
- Participated in regular meetings with physicians, nurses, case managers, coders, therapists. to discuss changes or improvements needed for clinical documentation processes.
- Conducted patient interviews to obtain additional information for medical record entries.
- Reviewed medical records to ensure accuracy and completeness of clinical documentation.
- Determined quality of care provided to patients through careful assessment of medical documentation.
- Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
- Returned dictated reports for physician's review, signature and corrections and inclusion in patients' medical records.
Registration Clerk
Promedica
adrian, MI
07.2013 - 08.2018
- Processed patient registrations and verified insurance information efficiently.
- Maintained accurate records in electronic health systems for easy access.
- Collaborated with medical staff to ensure a seamless patient service experience..
- Trained new clerks on registration procedures and system usage effectively.
- Implemented data entry protocols to enhance accuracy in patient information management.
- Communicated with insurance companies to confirm coverage details and eligibility status.
- Carefully checked insurance information for benefits coverage and input pre-authorization documents into system.
- Processed patient registration forms, collected fees, and issued receipts for services rendered.
- Registered patients for outpatient procedures and emergency services.
- Maintained confidential patient records according to HIPAA guidelines.
- Explained forms and documents to patients, guardians and family members, distributing copies and confirming comprehension.
- Performed data entry tasks to update patient information in the system.
- Scanned documents and insurance cards to include in patient charts.
- Asked various questions from clients to obtain the information necessary for paperwork.
- Responded to incoming department phone calls and directed callers to appropriate team members based on need.
- Assisted with training new staff members on proper procedures related to registering patients.
- Worked collaboratively with other departments to ensure smooth operations within the facility.
- Researched billing issues as needed and provided resolution to inquiries in a timely manner.
- Assisted with compiling documents required for insurance claims processing.
- Reviewed patient medical records and verified accuracy of information in the system.
- Generated reports regarding patient demographics and financial status.
- Investigated discrepancies between registrations and payments received.
- Conducted regular audits of patient files to ensure compliance with established standards.
- Protected medical information against unauthorized access, loss, or corruption by consistently following security protocols.
- Improved theintegrity and completeness of medical records by consulting with clinical staff to resolve coding and diagnostic mistakes.
Education
Bachelor of Science - Nursing
Siena Heights University
AdrianSkills
- Electronic health records
- Care coordination
- Patient assessment
- Clinical documentation
- Case management
- Patient education
- Effective communication
- Regulatory compliance
- Time management
- Attention to detail
- Conflict resolution
- Quality improvement
- Technology proficiency
- Verbal and written communication
- HIPAA compliance
- Insurance regulations
- Email and telephone etiquette
- Risk assessment
- Report writing
- Critical thinking
- Indirect patient care
- Medical records management
- Intervention plans
- Client advocacy
- Case documentation
- Interdisciplinary collaboration
- Utilization review
- Stakeholder collaboration
- Documentation proficiency
- Problem-solving
- Quality assurance controls
- Empathy and compassion
- Multitasking and organization
- Positive attitude
- Health history documentation
- Active listening
- Documentation and reporting
- Annual case reviews
- Data entry and analysis
- Clear communication
- Discharge planning
- Cost reduction initiatives
Certification
- RN License
References
References available upon request.
Timeline
Complex Case Manager
Cigna
07.2024 - Current
Registered Nurse, LTAC
Select Medical
01.2024 - 08.2024
Critical Care Registered Nurse
Travel Nursing Jobs
08.2023 - 12.2023
Critical Care Registered Nurse
ProMedica
08.2022 - 08.2023
Long-Term Care Registered Nurse
Burcham Hills Retirement Community
06.2019 - 01.2024
Registration Clerk
Promedica
07.2013 - 08.2018
Bachelor of Science - Nursing
Siena Heights University
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