Marian Presto

Email: abqpxs@r.postjobfree.com

Address: *** ****** **

City: Wadsworth

State: OH

Zip: 44281

Country: USA

Phone: 330-***-****

Skill Level: Management

Salary Range: $70,000

Primary Skills/Experience:

See Resume

Educational Background:

See Resume

Job History / Details:

Home Address

444 Summit St

Wadsworth, OH 44281

330-***-****

Marian Presto RN,CLNC,CHPN

Contact Information

abqpxs@r.postjobfree.com

Cell: 330-***-****

QUALIFICATIONS SUMMARY

Highly motivated, result-oriented RN and Legal Consulting professional with 35 years experience in the health care field, including acute care in the hospital setting, home health care, physician`s office, and Hospice. Knowledge of professional nursing procedures, policy and procedures and Medicare regulations with experience in QAPI. Excellent assessment and documentation skills, concise, accurate reporting skills. Focus on encompassing holistic patient approach to care, including psycho-social, spiritual and physical well-being, as indicated by experience in oncology/hospice care. Counseling of families and patients on end of life issues. Proven track record of investigation of issues with nursing facilities and patients with successful resolution. xtensivEe, thorough chart review skills. Recently obtained Certification as a Hospice and Palliative Care Nurse.

PROFESSIONAL EXPERIENCE

Crossroads Hospice - Assistant Clinical Director (QAPI), Case Manager, Team Leader Jan 2008-Present

* Managed a case load of 12-15 patients, with minimum visit pattern of twice/week. Responsible for building my caseload which resulted in a significant increase in referrals in all of the facilities in my area.

* Recognized by management for excellent organizational and documentation skills resulting in promotion to Assistant Clinical Director in charge of QAPI.

* Improved the accuracy of internal and external reports by utilizing Excel Program to efficiently track this data.

* Presided over the quarterly QAPI committee meeting to present the results of the aforementioned data, and key production indicators.

* Analyzed outcomes and wrote performance improvement proposals based on the outcomes of the data.

* Managed a team of 70-80 patients, 7-8 nurse case managers, and 8 STNA`s, providing telephonic support to visit staff, concurrent with position of QAPI nurse. Mentored staff in the field as necessary. Provided support to after hours staff.

* Reviewed all admission charts for supporting documentation, and assisted billing department in assigning appropriate ICD-9 codes...

* Educated new nursing staff to the documentation and developed a form for staff to utilize which provided organization of workflow.

* Assisted billing department in assigning appropriate ICD-9 code at time of admission.

* Resolved patient/facility complaints.

Akron City Hospital, Department of Angiography - Radiology Nov 2002-Oct 2008

* Routine duties of angiography nurse, assisting Interventional Radiologist in procedures and caring for patients before, during and after procedure.

* Took call on regular basis for emergent procedures, including traumas and stroke team.

* Maintained ACLS as required while working in this department.

* Coordinated the angio schedule on a rotational basis, working in emergent cases while maintaining the

Smooth operation of the scheduled procedures and seeing that procedures were completed in 8 hour time frame.

* Wrote the policy and procedure manual for angiography/special procedures department along with 2 other nurses.

* Performed periodic chart audits for our department for compliance.

Eshelman Legal Group - Medical Legal Nurse Consultant Oct. 2001-Nov. 2002

* Organized 2-3 years worth of charts in chronological order in preparation for review.

* Did extensive chart review and research on a large number medical malpractice and worker`s comp. cases.

* Educated legal staff on medical terminology, and what records would be important to retrieve and review.

* Identified key players in each case.

* Screened all medical intake calls for merit

* Continued contact with clients to update them on progression of case.

* Accompanied attorney to depositions and developed deposition questions.

* Wrote chronological outline of events for attorney to reference.

* Recognized by attorney for -generating the revenue- in the office. Due to extensive research and preparation, was integral in helping this legal team win one of their largest case awards.

Akron General Medical Center - Oncology (float), Care Coordinator July 1978-Oct. 2001

* Assisted in development the Care Management Department. Awarded the position of Care Coordinator in the Resource Center. In this position, served as clinical resource for the reimbursement specialists who called in the insurance reviews.

* Responded to all denials by reviewing records and initiating letters of appeal. Recovered more than $800,000.00 in the first three months of initiating this appeals process.

* Facilitated resolution of daily operational barriers within the Resource Center. Collaborated with multi-disciplinary team members in all phases of the discharge process.

* Facilitated covered-day reimbursement certification for patients using Interqual and Milliman and Robertson Criteria, and resolved problems with payers as needed.

* Served on the Quality Assurance Committee and sat on the Steering Committee for Denial Management.

* Obtained pre-authorizations as necessary.

* Reviewed all manner of patient charts, including psychiatric cases, and submitted appropriate information to the payers.

* Worked as a staff nurse at Akron General prior to Care Management. While a staff nurse, area of expertise was Oncology, with chemotherapy certification. Floated to every area of the hospital as needed, which helped me to develop a strong background in every area of nursing.Working the 12 hour every weekend shift for 15 years afforded me the opportunity to develop a very diverse and well rounded background by working in home IV therapy, home health care, and in physician`s offices during the week.

EDUCATION

Akron General Medical Center, School of Nursing (Diploma, RN) - 1978

Medical Legal Consulting Institute (Certification, Legal Nurse Consultant) - 1999

Certified Hospice and Palliative Care Nurse-2012

PROFESSIONAL MEMBERSHIPS

Oncology Nursing Society, National Hospice and Palliative Care Society, -Who`s Who Among Professionals-, Law Crossing

SKILLS

Computer: MS Word, MS Outlook, MS Excel, Experience learning proprietary software

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