Patient Care Prior Authorization

Ashley Matt

Shell Rock, IA ***** 563-***-**** ******.****@***********.***

Professional Summary

Multitasking Clinic Supervisor with a background ensuring courteous service to patients. Detail-oriented professional with exemplary skills in delegating tasks, issue resolution and leading by example. Offering proactive planning and organizational talents.

Skills

Onboarding and coaching

Clinical safety

Proficient in EPIC

Team meetings

Work History

Clinic Supervisor, 11/2013 to 10/2021

Wheaton Franciscan Healthcare – Waterloo, IA

Managed daily operations of 35-person clinic supporting approximately 2,000 patients per week

Delivered effective onboarding and training to new and existing employees and cross-trained staff members in other job roles to maximize coverage

Delegated tasks to staff members, monitored completion of all duties and provided support to enhance performance

Maintained clinic's records and files, utilizing proper techniques to keep patient data confidential

Discuss medications, insurance and prior authorization documents with patients and obtain prior authorization approval from insurance firms

Appealed insurance companies if prior authorization were refused.

Assessed patient accounts for completeness and accuracy.

Communicated with patients, asked appropriate questions and employed active listening to determine best care

Conducted interviews with participants to assess eligibility

Assisted with project planning and execution of research

Worked with department heads, staff and faculty to develop engaging curriculum and advance instruction for all nursing programs

Supervised and managed daily activities of clinical team consisting of physicians, nurses and support staff

Monitored unit budget to ensure financial objectives were met

Strategically planned methods to achieve operational goals and targets

Identified process improvements in day-to-day functioning of department

Evaluated patient care needs, prioritized treatment, and maintained patient flow

Continually maintained and improved company's reputation and positive image in markets served

Assisted in resolving and satisfying client requests and internal operational issues

Actively participated on the EPIC Superuser team

Registered Nurse, 02/2012 to 10/21

Wheaton Franciscan Healthcare – Waterloo, IA

Delivered outstanding care to patients with various diagnoses and managed care from treatment initiation through to completion

Conferred with physicians to discuss diagnoses and devise well-coordinated treatment approaches

Contributed substantially to successful department JCAHO accreditation by consistently operating to highest standards of care

Led teams in driving successful patient outcomes by prioritizing standard of care and best practices

Provided direct patient care, stabilized patients and determined next course of action

Performed triage on all incoming patients and determined severity of injuries and illnesses

Licensed Practical Nurse, 02/2010 to 03/2012

Good Samaritan Society – Postville, IA

Managed patient care through closely monitoring respiration, blood pressure and blood glucose levels

Gathered dietary information, assisted with feeding and monitored intake to help patients achieve nutritional objectives and support wellness goals

Applied interpersonal communication skills to comfort and counsel patients and families throughout care process

Monitored, tracked and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery

Evaluated patients to identify and address wounds, behavioral concerns and medically-relevant symptoms

Cared for wounds, provided treatments and assisted with procedures

Kept optimal supply levels in treatment rooms, triage and other areas to meet typical patient loads

Administered medications and treatments to patients as ordered by physician, maintaining accountability for accurate narcotic count at end of each shift

Trained new nurses in proper techniques, care standards, operational procedures and safety protocols to optimize performance and safety

Patient Care Associate, 09/2007 to 02/2010

Goodwill Industries Of NE Iowa – Decorah, IA

Developed rapport to create a safe and trusting environment for care of the disabled and handicapped

Assisted in the development of goals for those who have barriers preventing them from otherwise obtaining a job

Certified Dental Assistant, 07/2006 to 07/2007

Dental Associates – Prairie Du Chien, WI

Prepared rooms for patient treatment by cleaning and sterilizing tools and equipment

Educated patients on dental hygiene, pre-surgical instructions and post-surgical care

Administered sealing compounds and protective coatings to boost tooth enamel strength and minimize cavity risk

Completed tooth impressions to support creation of accurate dental work to correct problems such as missing teeth

Cleaned and sterilized instruments between patients to protect from infection risks

Taught patients successful strategies for boosting oral hygiene, controlling plaque and protecting gums and tooth enamel from damage

Assisted dentists by passing instruments, suctioning intraoral fluids, adding water and mixing materials for fillings, casts and impressions

Prepared bitewing, panoramic and periapical radiological images, allowing dentist to spot cavities, decay and problem areas needing treatment

Triage Nurse -Waverly, IA

Answered 60-70 calls per day

Directed patients to appropriate care

Scheduled appointment for our patients

Assisted on the floor as needed to take care of our patients

ADON/MDS Coordinator- Shell Rock, Iowa

Monitored patient care by assessing procedures

Responsible for setting RUG levels for each resident and ensuring the facility in getting accurate, and maximum reimbursement

Initiated patient charts with correct ICD-10 and CPT codes

Initiated and updated Care Plans

Ensured compliance and extensive laws surrounding nursing home residents

Assisted nursing staff as needed

Administered and managed assessments of residents in the facility

Gathered data on the facility’s current and future residents

Followed up on complaints and incidents reported by residents

Education

High School Diploma: 05/2005

Valley Community High School - Elgin, IA

Certificate : Dental Assisting, 06/2006

Hawkeye Community College - Waterloo, IA

Associate Degree in Nursing: Nursing, 12/2012

Northeast Iowa Community College - Calmar, IA

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