Travis Meeks
Appeals Nurse
Bloomington
Summary
Effective Medical Claims Processor with strong background building rapport with providers to discuss claim status or claim denials. Driven performer equipped to handle multiple administrative tasks effectively. Exemplary worker with highly investigative skills when processing claims.
Bringing compassionate and patient-centered approach, combined with solid understanding of patient care principles and medical protocols. Proficient in administering treatments and using medical technology to monitor patient progress. Dedicated to improving patient outcomes and providing high-quality care.
Overview
13
13
years of professional experience
8
8
years of post-secondary education
Work History
Dialysis Registered Nurse
Fresenius Medical Care Dialysis
10.2024 - Current
- Administered medications and treatment to patients and monitored responses.
- Collaborated with interdisciplinary team members to ensure comprehensive care for all patients undergoing dialysis.
- Kept current with industry advancements through ongoing professional development, attending conferences, workshops, and seminars relevant to the field of nephrology nursing.
- Increased patient safety by adhering to strict infection control protocols throughout the entire dialysis process.
Appeals Nurse
Elevance Health
07.2021 - Current
- Intakes, prioritizes and reviews relevant information for both inpatient and outpatient services to ensure complete case summary that is provided to the Medical Director for appeal review. Met unit quality and production goals within three months.
- Responsible for writing, reviewing and sending approval and denial letters to providers and members. Ensure compliance with responses and resolution of an appeal case within the health plan's set due dates. Perfect quality audits for over 14 months.
- Consult with clinical reviewers and/or medical directors to ensure medically appropriate, high-quality, cost-effective care throughout the medical management process.
- Meet Elevance Health's business pillars by being flexible and meet business needs. Volunteered to take on colleague's workload while on maternity. Average case load was over 100 cases per day during this time period while meeting case turn around mandates.
- Worked in 4 separate state markets in just 12 months.
Utilization Review Nurse
Elevance Health
01.2019 - 07.2021
- Reviews pre-authorization services and inpatient stays to ensure correct decisions according to health plan policy and Milliman Care Guidelines. Scored greater than 98% on quality and compliance audits.
- Responsible for writing, reviewing, and sending approval/denial letters to providers and members.
- Spoke with clients and providers explaining how insurance reviews works, and how to provide clinical documentation and what clinical documentation is needed for approval. Received unit recognition for exemplary service from members.
- Volunteered for a pilot program during the covid outbreak to make cold calls to members to screen for financial needs and educate members resources. Made over 50 calls per day for a three month period.
Clinical Review Nurse
Elevance Health
07.2018 - 12.2019
- Ensures medically appropriate, high quality, cost effective care through medical claims review, assessing the medical necessity of post service reviews, admissions, outpatient services, focused surgical and diagnostic procedures, and out of network services Essential duties may include, but are not limited to: retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts. Scored 99.1 on compliance audits. Worked with team members to reduce work volume by 50% over the first nine months. Exceeded personal production goals in the first year.
- Consulted with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management process.
Triage Nurse II
Elevance Health
08.2012 - 08.2018
- Collaborated with care management team to identify issues, problems, and assign to appropriate care management program.
- Screened high acuity patients and used motivational interviewing to overcome objections. Enrolled team best number of members.
- Participate in departmental meetings to ensure sound communication, and to contribute ideas for improving processes, productivity, and Member engagement. Volunteered for pilot programs that helped shape department initiatives for our intravenous pharmacy drugs.
- Educate members about what types of services case management can provide. Increased Elevance health's market share and profit.
Education
Associates - Nursing
Ivy Tech Community College
Bloomington, IN 01.2006 - 05.2008
Bachelor's Of Science - Economics
University of Southern Indiana
Evansville, IN 01.1998 - 05.2003
Skills
AIM Clinical Guidelines
Milliman Care Guidelines
Elevance Health plan guidelines and medical policies
Microsoft word, excel, office
Pega, Nextgen, ACMP, HRS
Timeline
Dialysis Registered Nurse
Fresenius Medical Care Dialysis
10.2024 - Current
Appeals Nurse
Elevance Health
07.2021 - Current
Utilization Review Nurse
Elevance Health
01.2019 - 07.2021
Clinical Review Nurse
Elevance Health
07.2018 - 12.2019
Triage Nurse II
Elevance Health
08.2012 - 08.2018
Associates - Nursing
Ivy Tech Community College
01.2006 - 05.2008
Bachelor's Of Science - Economics
University of Southern Indiana
01.1998 - 05.2003
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