MELISSA PRUITT
Deltona,FL
Summary
Dedicated Registered Nurse with over 9 years of acute-care experience, skilled in care coordination, discharge planning, and patient education. Expertise in insurance verification, prior authorization, and medical documentation, with a proven ability to collaborate effectively with multidisciplinary teams. Strong advocate for patient-centered care, prioritizing complex needs while ensuring continuity of services.
Overview
1
1
Certification
16
16
years of professional experience
Work History
NURSE LEADER
AdventHealth
Orange City, FL
10.2019 - Current
- Lead shift operations for a fast-paced inpatient nursing unit, coordinating staffing assignments, delegating responsibilities, and prioritizing patient-care needs to promote safe and efficient care delivery.
- Collaborate with interdisciplinary team members, including physicians, case managers, and nursing staff, to coordinate care and address clinical and discharge needs, enhancing patient outcomes.
- Facilitate discharge planning and transitions of care by reinforcing treatment plans, medication instructions, follow-up needs, and post-discharge recommendations.
- Identify potential barriers affecting discharge readiness and work with the interdisciplinary team to facilitate appropriate resources, services, education, and follow-up.
- Perform clinical escalation and telephone triage while using nursing judgment to identify changes in condition, determine appropriate interventions, and coordinate timely follow-up.
- Advocate for patients by communicating changes in clinical status, care needs, and concerns to appropriate members of the healthcare team.
- Coach, mentor, and support nursing staff while reinforcing patient-safety standards, clinical best practices, and effective interdisciplinary communication.
REGISTERED NURSE
AdventHealth
Orange City, FL
10.2017 - Current
- Provide comprehensive nursing care to patients with acute and chronic medical conditions, including assessments, care planning, interventions, education, and evaluation of outcomes.
- Conduct ongoing assessments to identify changes in patient condition, emerging risks, and educational needs, addressing potential barriers to recovery or discharge.
- Collaborate with physicians, case managers, therapists, social workers, and other healthcare professionals to develop and implement individualized plans of care.
- Administer medications and treatments while monitoring therapeutic response, adverse effects, and changes requiring escalation.
- Educate patients and caregivers regarding diagnoses, medications, treatment plans, warning signs, follow-up care, and strategies for successful disease self-management.
- Participate in discharge planning and coordinate with the interdisciplinary team to promote safe transitions from the inpatient setting to home or the next level of care.
- Advocate for patient needs by effectively communicating concerns and barriers to interdisciplinary team members, facilitating timely interventions.
- Precept nursing students and newly hired nurses, enhancing their clinical judgment, prioritization, communication, and adherence to safe patient-care practices.
PRIOR AUTHORIZATION SPECIALIST
Boston Diagnostic Imaging
Altamonte Springs, FL
11.2010 - 08.2015
- Processed prior authorization and pre-certification requests for diagnostic imaging services across Medicare, Medicaid, and commercial insurance plans.
- Verified patient insurance eligibility, coverage, and authorization requirements, ensuring compliance with payer-specific documentation.
- Coordinated with physician offices, patients, insurance companies, and internal departments to resolve authorization barriers and prevent unnecessary delays in scheduled services.
- Coordinated with physician offices, patients, and insurance companies to resolve authorization barriers, minimizing delays in scheduled services.
- Managed payer notifications and appeals while maintaining accurate documentation of authorization status and communication.
- Resolved insurance and authorization issues by initiating appropriate follow-up actions.
- Maintained confidentiality and compliance with HIPAA and organizational requirements while handling protected health information.
Education
Bachelor of Science - Nursing (BSN)
Daytona State College
Daytona Beach, FLAssociate of Science - Nursing (ASN)
Daytona State College
Daytona Beach, FLSkills
- Care Coordination & Patient Advocacy
- Discharge planning
- Patient Needs & Barrier Assessment
- Interdisciplinary coordination
- Clinical Assessment & Judgment
- Patient and Family Education
- Admissions and discharges
- Prior authorization
- Insurance Verification & Benefits
- Appeals & Payer Communication
- Documentation review
- Medication and Treatment Education
- Epic & Oracle Cerner EMR
- Electronic medical records
- HIPAA Compliance
- Problem Solving & Prioritization
- Additional: Microsoft Office Suite, Electronic Documentation, Insurance/Payer Systems
Certification
Registered Nurse (RN) — Florida, Active, Multistate Compact License (NLC)
License #RN9464693
BLS Certification — American Heart Association
ACLS Certification — American Heart Association
LANGUAGES
Title: Registered Nurse | Care Coordination | Case Management
AWARDS
Title: Registered Nurse | Care Coordination | Case Management
Timeline
NURSE LEADER
AdventHealth
10.2019 - Current
REGISTERED NURSE
AdventHealth
10.2017 - Current
PRIOR AUTHORIZATION SPECIALIST
Boston Diagnostic Imaging
11.2010 - 08.2015
Bachelor of Science - Nursing (BSN)
Daytona State College
Associate of Science - Nursing (ASN)
Daytona State College