Monica Lane
North Richland Hills
Summary
Dynamic nursing professional with extensive experience in prior authorization and regulatory compliance at Ageless Living Home Health. Proven ability to streamline authorization processes and enhance interdisciplinary collaboration. Skilled in patient documentation and clinical assessment, consistently achieving timely approvals and improving patient care outcomes.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Prior Authorization Nurse- Manager
Ageless Living Home Health
Arlington
11.2021 - Current
- Coordinated authorization requests for home health services and resources.
- Reviewed patient files to ensure compliance with insurance requirements.
- Communicated with healthcare providers to gather necessary documentation.
- Managed follow-up communications with insurance companies for approvals.
- Assisted team members in resolving complex authorization issues.
- Maintained accurate records of authorization status and updates.
- Collaborated with interdisciplinary teams to streamline authorization processes.
Medically Fragile Pediatric Home Health LVN
Thrive Skilled Pediatric Care
Fort Worth
01.2019 - 11.2021
- Provide nursing care as ordered by a physician and designated in the nursing plan. Includes vital signs, wound care, tracheostomy and GB care, administration of oral, IV, and tubal meds., phlebotomy, and Foley/Supra-pubic catheter care.
- Prepare and complete patient documentation, participate in care-plan and monthly reviews.
- Weekly interaction with patient's healthcare providers and review and finalization of doctor's orders.
QA/OASIS LVN
Renew Home Health
Fort Worth
01.2017 - 01.2019
- Provided patient chart audits, ensured all physician orders were present, audited 485 and plan of cares, ensured correct frequency of visits.
- Performed weekly OASIS validation report corrections, and reviewed all F2F encounters for SOC's.
Pediatric Home Health Nurse
Maxim Healthcare
Fort Worth
08.2010 - 01.2017
- Provide nursing care as ordered by a physician and designated in the nursing plan. Includes vital signs, wound care, tracheostomy and GB care, administration of oral, IV, and tubal meds., phlebotomy, and Foley/Supra-pubic catheter care.
- Prepare and complete patient documentation, participate in care-plan and monthly reviews.
- Weekly interaction with patient's healthcare providers and review and finalization of doctor's orders.
Education
Vocational Nursing Program -
Concorde Career College
Arlington, TX04-2007
Skills
- Prior authorization
- Regulatory compliance
- Patient documentation
- Interdisciplinary collaboration
- Insurance verification
- Clinical assessment
Certification
TXBON LVN
Timeline
Prior Authorization Nurse- Manager
Ageless Living Home Health
11.2021 - Current
Medically Fragile Pediatric Home Health LVN
Thrive Skilled Pediatric Care
01.2019 - 11.2021
QA/OASIS LVN
Renew Home Health
01.2017 - 01.2019
Pediatric Home Health Nurse
Maxim Healthcare
08.2010 - 01.2017
Vocational Nursing Program -
Concorde Career College
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