Summary
Overview
Work History
Education
Skills
Accomplishments
References
Timeline
Generic

Patricia Thomas

Apache Junction,AZ

Summary

Compassionate Nurse known for high productivity and efficient task completion. Skilled in medical documentation. Excel at communication, empathy, and teamwork to enhance patient care and support colleagues.

Overview

16
16
years of professional experience

Work History

Appeals Nurse

Evolent Health
Apache Junction, AZ
01.2023 - Current
  • Facilitated communication between payers, providers and patients concerning authorization issues or concerns.
  • Provided education to providers regarding utilization management processes and protocols.
  • Discuss clinical information with providers
  • Discuss information with patients that is needed for an authorization

Appeals Nurse

NIA Magellan
Apache Junction, AZ
05.2008 - 01.2023
  • Maintained knowledge base on current coding practices, government regulations, payer requirements.
  • Performed quality assurance audits on completed utilization review cases.
  • Documented all activities related to utilization management in the electronic medical record system.
  • Identified opportunities for improved quality of care through review of clinical documentation.

Education

LPN - Nursing Practice

McDowell County Career And Technical Center
Welch, WV
08-1984

Skills

  • Policy and procedure compliance
  • Review clinical for appeal approvals of denied imaging and procedures
  • Work with physicians to obtain correct clinical to approve imaging and procedures
  • Meet all timelines per HP policies

Accomplishments

  • I have received multiple super bonuses along with quarterly bonuses over the last 16 years

References

References available upon request.

Timeline

Appeals Nurse

Evolent Health
01.2023 - Current

Appeals Nurse

NIA Magellan
05.2008 - 01.2023

LPN - Nursing Practice

McDowell County Career And Technical Center

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Patricia Thomas