Patricia Smith
Walnut Hill,ME
Summary
Detail-oriented and dependable registered nurse with 10 years combined acute care, rehabilitation and long-term care nursing experience.
Medical record documentation review and audit experience combined with clinical knowledge. Experience with ICD 10/DRG coding, Medicare guidelines, prior authorization and appeals.
A positive ability and adaptable. Able to work independently and part of a team.
Remote working experience, home office with high-speed internet available.
Ability to navigate computer systems including EMR systems, Microsoft office, Zoom and Microsoft teams.
Overview
7
7
years of professional experience
Work History
Charge Nurse
Oceanview Falmouth House
09.2021 - Current
- Consistently provided high quality care to assisted living residents,
- Effective communication and teamwork with physicians, therapists, and support staff.
- Comprehensive assessments of patients physical, emotional and social needs.
- Mentored and supervised staff, fostering a supportive and professional work environment.
Medical Reviewer Nurse III
Empower AI
11.2021 - 01.2023
- Review of CMS claims for accuracy and completeness.
- Utilized resources to determine if CMS guidelines for claims were met.
- Use of EMR systems to store, receive and process medical record data.
- Communicated effectively with coworks, supervisors by phone and computer.
- Provided timely updates on claims.
Clinical Care Nurse
Portland Gastroenterology Associates
07.2021 - 03.2022
- Enhanced patient care by supporting patients questions and concerns with upcoming appointments.
- Triaged patients medical concerns for physicians. Effective communication to physicians and patients to resolve medical issues.
- Worked with prior authorizations for prescribing physicians.
- Scheduled procedures, reviewed schedule for 15 physicians.
- Improved patient satisfaction ratings by delivering compassionate and personalized care.
Clinical Documentation Specialist
Northern Light Mercy Hospital
12.2016 - 08.2018
- Improved clinical documentation quality by conducting thorough reviews and providing feedback to healthcare providers.
- Enhanced patient care by ensuring accurate and complete medical records through timely and efficient documentation practices.
- Contributed to revenue optimization by identifying opportunities for appropriate clinical documentation improvement.
- Collaborated with multidisciplinary teams to develop best practices in clinical documentation, streamlining processes and reducing errors.
Education
Bachelor of Science - Nursing
University of Southern Maine
Portland, ME12.2004
Associate of Science - Nursing
Southern Maine Community College
South Portland, MESkills
- RN BSN licensed in compact state (Maine) and Massachusetts
- Medical Record Auditing
- Chronic Disease Management
- Analytical and Critical Thinking skills
- Dependable and Responsible
- Proficiency with Microsoft office and EMR systems
- Self-Motivated
- Written Communication
- Decision-Making
- Teamwork and Collaboration
Timeline
Medical Reviewer Nurse III
Empower AI
11.2021 - 01.2023
Charge Nurse
Oceanview Falmouth House
09.2021 - Current
Clinical Care Nurse
Portland Gastroenterology Associates
07.2021 - 03.2022
Clinical Documentation Specialist
Northern Light Mercy Hospital
12.2016 - 08.2018
Bachelor of Science - Nursing
University of Southern Maine
Associate of Science - Nursing
Southern Maine Community College
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