Experience

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  Baltimore City Community College

  • Clinical Coordinator

    • Oct 2017 - Apr 2018

    Setting up clinicals for CNA, GNA, Venipuncture, and Pharmacy students. Reaching out to probable clinical sites to obtain new contracts. Testing students and occasional taking them to MBON for paper applications completion.

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  Spherion Professional Services

  • Nurse Clinical abstractor

    • Dec 2007 - Jun 2010

    -Perform in-depth review of patient records from hard-copy medical records for the purpose of abstracting clinical information. -Facilitate improvement of the overall quality and completeness of clinical documentation for entry into the EPICcare clinical system. -Verify clinical diagnosis matches ICD-9 coding. QI all charts for correct documentation of transferred material and training of new employees.

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  Maryland Physicians Care

  • Prior Authorization Nurse

    • Nov 2005 - Sep 2007

    -Reviewed, verified, and processed request for referrals, diagnostic testing, inpatient admission, outpatient procedure, home health, emergency room, durable medical equipment and supplies. -Identified QI and Case Management issues. Reviewed and corrected documentation for ICD-9 and CPT-4 coding.

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  Family Health Centers of Baltimore

  • LPN Adult Medicine Supervisor

    • Mar 2005 - Nov 2005

    Supervise a staff of 2 Medical Assistants and 1 Staff Registration person. -Assist physicians with referrals and medication distribution. -Telephonic and in person triage of patients. Ordering Medications and calling in prescriptions. ---Completing documentation for authorization for surgeries and medical equipment with appropriate ICD-9 coding attached.

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  Care Resources, Inc

  • School Health Nurse

    • Oct 2002 - Mar 2005

    Worked under the supervision of a R. N. and Health Department. -Supervised and assist health aides in school setting. -Assessed and triage health complaints and dispense medications as needed. -Counted medications and keep updated logs and forms to be reviewed by the Health Department.

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  NRI Staffing Resources

  • Case Management Technician

    • Apr 2004 - Sep 2004

    Processed complex occupational illness claims for former contract atomic weapons workers and survivors. -Supported Case Managers in examining illness and survivor claims for factual and medical sufficiency and legal correctness. -Initiated claimant contact, tracked requested documents, interface with Case Managers, Nurses, Assistants, and other personnel as required ensuring adequate communication regarding status and activity required for processing an applicant claim. -Utilized Case Management System to track and update status of claims and responded to inquiries regarding status of claims.

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  TheraCom, Inc

  • Program Specialist

    • May 2002 - Oct 2002

    Insurance verification of benefits for Commercial, Medicare and Medicaid insurances for facilities, and private Physician offices by supplying correct ICD-9 and CPT-4 coding for billing purposes. -Assisted with the appeals process of denied claims and writing of letters of medical necessity. -Faxed and mailed of product literature and coding information. -Contacted patients for Co-payments and explained billing services. -Verified pharmacy coverage on-line.

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  Greenbelt Endoscopy Center

  • Room Nurse

    • Apr 2001 - Mar 2002

    Communicated with physician offices for posting of procedures. -Assist physicians with procedures. Label and send specimens. -Provide daily check of crash cart equipment. -Assist in recovery room and education of patients upon discharge. -Keep daily room record of all narcotics used.

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  Prudential Healthcare

  • Pre-Certification Nurse

    • Jun 1998 - Dec 2000

    Advised physicians and/or providers of State mandates. -Made referral to medical director for denial when indicated. -Communicated proactively to managing physicians and/or other providers' alternative levels of care available for medical services. -Set-up discharge planning. -Maintained NCQA standards for notification and letter generation. -Identified QI and Case Management issues. -Provided training for departmental associates. -Utilized knowledge of Interqual and Milliman and Robertson criteria, HCFA, and COMAR, ICD-9 and CPT-4.

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  Maryland Physicians Care

  • Authorization Nurse

    • Oct 1997 - Jun 1998

    Reviewed, verified, and processed request for referrals, diagnostic testing, inpatient admission, outpatient procedure, home health, emergency room, durable medical equipment and supplies. -Set up referrals for REM. Coordinated care for Medicaid members. -Verified pharmacy billing and authorizations. Reviewed and corrected documentation for ICD-9 and CPT-4 coding.

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  Total Health Care

  • Pediatric Exit Nurse

    • Mar 1995 - Oct 1997

    Registered patients -Reviewed labs, ordered immunizations and was liaison between clinic and state agencies. -Implemented systems for tracking patients with delinquent immunizations, lead poisoning and sexually transmitted diseases. -Input referrals, made appointments for repeat testing, logged referrals and authorizations. SKILLS Word 7.0, Excel, PowerPoint, Nursing, Customer Service, Typing, Filing, WIC, Workers Compensation, Occupational Health, ICD-9, CPT-4, EPIC trained.