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
2023.01 - 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
2008.05 - 2023.01
- 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, WV1984-08
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
2023.01 - Current
Appeals Nurse
NIA Magellan
2008.05 - 2023.01
LPN - Nursing Practice
McDowell County Career And Technical Center
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