Licensed Vocational Nurse

South Louisiana Community College — Associate Degree Licensed Vocational Nursing
3.33GPA AUGUST 2004 – MAY 2006, LOCATION: 1101 Bertrand Dr. Lafayette, LA 70506
(337) 521-9000 [email protected]
South Louisiana Community College — Associate Degree Computer Specialist 3.00GPA
AUGUST 1994 – MAY 1996, LOCATION: 1101 Bertrand Dr. Lafayette, LA 70506
(337) 521-9000 [email protected]

eviCore healthcare 400 Buckwalter Place Blvd. Bluffton, SC 29910 Phone:
1-800-918-8924 — Remote Prior Authorization Nurse
MARCH 16 2016 – PRESENT
● Receive, verify and complete prior authorizations requests from Imaging Centers,
Hospitals, Health Plans and Doctors offices
● Keep medical staff in the loop about any delays or problems in obtaining prior
authorizations by phone / fax.
● Verify patients’ benefits and ensure that proper prior authorization and reconsideration is
obtained
● Worked with 20 plus healthcare plans which affected more than 30 million lives
● Communicated daily with members and doctors throughout the clinical appeals process
● Remain Hipaa compliant and familiar with federal and state Medicaid policies and
procedures
● Assigned proper (ICD-10) Medical Diagnosis Codes and (CPT) Medical Service Codes
based on clinical information provided.
● Reviewed and researched members medical records to verify/substantiate diagnosis and
treatment performed.
● Resource for newly hired Clinical Review Nurses
● Performed various data entry tasks, placed calls to providers in an effort to remediate and
approve denied claims using Evicore, Milliman and InterQual Criteria / Guidelines
● Meet regulatory turnaround times and departmental productivity goals
Hillcrest of North Dallas 18648 Hillcrest Road Dallas, TX 75252 Phone: 972-517-7771
— Licensed Vocational Nurse
JULY 15 2015 – MARCH 01 2016
● Assisted in the care of geriatric members with declining physical health
● Maintained awareness of comfort and safety needs for 35-40 patients
● Monitored and treated members recovering from CVA’s, MVA’s, head trauma, total knee
or hip replacements
● Involved in ongoing teaching with the patient and their family members regarding patient
care and additional therapy needs.
● Initiated and maintained IV access, foley catheters, nasogastric tubes, assisted with
medications
Maxim Health 5001 Lyndon B Johnson Fwy Suite 900, Dallas, TX 75244 Phone: (214)
370-3385 — Licensed Vocational Nurse
MARCH 15 2015 – DEC 30 2015
● Compassionately provided flu shots in a clinical setting.
● Extensive understanding of vaccine safety control procedures
● Adept at monitoring patients during the process of administering vaccines
● Strong knowledge of flu vaccines including storage requirements
● Ability to work efficiently with minimal supervision
● Capable of working flexible schedules
● Pediatric home health care
● Administered nursing services, medications and treatments
Nurse Corps LLC 322 S Market St, Opelousas, LA, 70570-5142 Phone: (337) 948-7271
— Agency Nurse (Multiple Specialties)
MAY 05 2006 – JUNE 01 2010
● Worked in a pediatric unit-responsible for critical care members
● OB Care, assessment/evaluation of neonatal and postpartum patients.
● Geriatric Rehabilitation care
● Pre- and Post-Operative Care, Medication and IV administration, Wound Management
● Patient Management, Discharge planning
● Worked in a 16 bed lockdown dementia unit
Our Lady-Prompt Succor 954 E Prudhomme St, Opelousas, LA 70570 Phone: (337)
948-3634 — Licensed Vocational Nurse
MAY 05 2004 – MAY 30 2006
● Responsible for care of a 30 bed geriatric unit.
● Supervised and mentored 2-4 Certified Nursing Assistants.
● Administration of daily medications
● Tracheostomy care including wound-VAC maintenance, wound cleaning and changing
catheters and dressings.
● Administered nebulizer treatments, intramuscular and subq injections,
● Monitored blood glucose levels in diabetic patients
● Transmitted pharmaceutical prescriptions for dispensing and interfaced with pharmacists
on dosages and refills.
● Assessed at-risk patients, interfaced with physicians, implemented prescribed protocols
and formulated patient care as ordered
● Acted as a preceptor for new Certified Nursing Assistants

• ● Prior Authorization, Concurrent and Medical Health Claims Review processing experience.
• ● ICD-10 Medical Billing & Coding, Milliman and InterQual Criteria experience.
• ● Strong interpersonal and communication skills with the ability to work efficiently with
• minimum supervision.
• ● Skilled and knowledgeable in the use of Zoom, Excel, CDP, DOS, HTML, Cloud computing,
• SharePoint/Teams, Ultipro, Dropbox, Video Conferencing, Cisco Jabber, Webex, SharePoint,
• Microsoft Word, Excel, PowerPoint, Outlook, Google Suite (Docs, Sheets, Slides) Chrome,
• Cherwell, ImageOne, CDP, Case Management, Carecloud, Allscripts, Mckesson, Meditech,
• Athena.
• ● Provided at the elbow support and training for 2-6 Certified Nursing Aides
• ● Vast knowledge of various EHR programs “Epic, Cerner, Nextgen, eClinicalWorks”.
• ● Three months intensive psychiatric clinical rotation.
• ● Experienced in Med-surg, Geriatrics, Rehab, LTAC, Memory Care, Managed Care, Utilization
• Management, Psychiatric, Dementia, Pediatrics, Home Health, Community Health

Community Health, Dementia, Geriatrics, Home Health, LTAC, Managed Care, Med-surg, Memory Care, Pediatrics, Psychiatric, Rehab, Utilization Management

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