New Graduate Registered Nurse with 16 years of Licensed Practical nursing experience acting as nursing leader, operational problem-solver and conflict manager. Well-versed in working with sub-acute rehab and long term care patients. Expertise in medication administration, accurate charting, wound care, infection control, EMR systems (Point Click Care, Epic). Coordinates employee assignments and workflow to promote high-quality patient care.
Review patient medical records to obtain clinical information
Communicate with the insurance provider to determine coverage eligibility as well as to ensure authorization meets requirements, regulations, and contractual obligations
Communicate with providers at the insurance company to provide additional clinical information for denied authorizations
Complete medical necessity and level of care reviews for requested services
Obtained Pre-authorizations for procedures.
BLS
BLS