Work-From-Home Patient Care
Resume:
BEA MARIE JAVELLANA
C l i n i cal Administrative Nurse
CONTACTS
Phone Number:
Email:
beamariejavellana@gmail
.com
Address:
Philippines, 1700
ABOUT ME
I have 7 years of
experience as a nurse
with my expertise focused
on Patient Care
Coordination, Utilization
Management, and
Medical Records in a US-
based healthcare setting.
SKILLS
Utilization Managment
Clinical Coordination
Critical Thinking
Patient Assessment
Speed & Punctuality
Systematic Organization
Administrative Writing
Skills
Scheduling
Medical Claims Review
LANGUAGES
English
WORK EXPERIENCE
Clinical Administrative Nurse
Optum Global Solutions / Oct 2023 - Present
Full time / Work-From-Home
• Currently working under Medical Claims Review
• Performs clinical coverage review of services, which require interpretation of state and federal mandates, applicable benefit language, and consideration of relevant clinical information
• Completes both approval and denial coverage determinations according to applicable medical policy and guidelines
• Prepares cases for physician review
• Function as a member of a self-directed team to meet specific individual and team performance metrics
• Communicates in writing and verbally, all types of benefit determinations including decisions regarding coverage guidelines, contractual limitations and reimbursement determinations
• Telephonic discussion with health care providers and members to explain benefit coverage and medical necessity determinations and to obtain additional clinical information
Healthcare Administrative Nurse
StatCare Northside Pulmonary & Sleep Clinic / St. Petersburg, Florida, USA
/ Sep 2022 - Jan 2023
Full time Remote work / Work-From-Home.
• Calls patients to follow up on pending tests ordered by the doctor e.g. Chest CT Scan, PET CT Scan, CMP, CBC, etc.
• Calls hospitals, facilities, and providers to check on the status of referrals, scheduling and appointments, and test results of patients.
• Prepares and assembles medical charts / clinicals for physicians and Nurse Practitioner.
• Transcribes medical record documentation utilizing electronic medical record applications.
• Ensures medical record compliance by self-documentation attestation. Sta Nurse / COVID-19 Swab Nurse
Javellana Medical Clinic / Jan 2022 - Aug 2022
• Responsible for ensuring the delivery of safe, high quality sample collection.
• Ensures sta and clients are protected against risks through the provision of appropriate standards consistent with good clinical practice.
• Provides swabbing services to clients prior to their outpatient procedures or admission.
• Works collaboratively with other members of the general practice team to meet the needs of the patient.
• Initiates and manages a methodical assessment of patient needs including public health, health education and promotion in consultation with the physician.
• Assists in the development of clinical protocols and guidelines in addition to audit such as infection control.
• Ensures the maintenance of equipment, storage of vaccinations and stock levels relating to patient care.
English Teacher
Engoo Global / Feb 2020 - Dec 2021
Part-time
• Consulted with teachers in English and English disciplines to identify and adopt successful instructional strategies.
• Completed in-service and additional training to maintain professional growth.
• Helped students develop important learning skills and good study habits useful in trade school or college education.
• Explored and implemented innovative use of technology in language education.
• Wrote English reading list for students, catering choices to modern student interests and class types.
Company Nurse
G&A Realty Corporation / Feb 2019 - Dec 2021
• Provides basic first aid to all employees such as dispensing of medicines, BP monitoring, etc.
• Maintains and updates all clinic records and files.
• Ensures that employee health records are monitored, and flags issues as needed.
• Provides needed support to company programs related to healthy living and working conditions.
• Aids employees requiring confinement.
• Reviews results of pre-employment medical exams as well as annual physical exams.
• Facilitates conduct of annual physical exam through coordination with Maxicare.
• Handles requirement for FTW, sick leave approval and medical clearance.
• Conducts monthly orientation of medical benefits for newly regularized employees.
Clinic Nurse
Javellana Medical Clinic / Jul 2016 - Jul 2017
• Delivered high-quality care to diverse populations while overseeing patient admission and triaging based on acuity and appropriate department admission.
• Sustained quality standards by performing routine medication audits and upholding internal and industry best practices.
• Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
• Vaccinated patients to protect individuals from measles, pneumonia, influenza, and other illnesses of concern.
• Educated family members and caregivers on patient care instructions.
• Promoted patient and family comfort during challenging recoveries to enhance healing and eliminate non-compliance problems.
• Observed and reported patient condition, progress, and medication side e ects to accurately document updates.
• Communicated with healthcare team members to plan, implement, and enhance treatment strategies.
EDUCATION
Bachelor of Science:
Nursing
Sampaloc, Manila & University Of
Santo Tomas
2016
M.D.: Medicine
(Undergraduate)
Fairview, Quezon City & Far Eastern
University - NRMF
2019
CERTIFICATIONS
HIPAA
Dec 2022
BOSH
Oct 2023
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