Review Nurse Data Entry
Resume:
NANCY L. ORR
**** ** ******* *** ****, OH ***** 614-***-**** CELL PHONE
*************@************.***
Retired as an RN since January 1, 2015. I am seeking a position as a remote customer service representative or data entry employee.
32 years of telephonic customer service experience
Expert level with Microsoft Outlook, Word, and Excel
Excellent written and verbal communication skills
Active listening skills. Can express sympathy and empathy so that the caller recognizes these emotions.
Authorized to work in the US for any employer
EXPERIENCE
APPEALS NURSE
AETNA INSURANCE COMPANY - New Albany, OH
April 2011 to December 2014
Effective counseling in the Appeals process.
Experience with various medical conditions including Diabetes, Cancer, Alzheimer's and
Dementia, work related injuries and Rehabilitation.
Experience in reviewing written appeals as well as verbal appeals.
Effective decision-making skills based on available information and Aetna's criteria.
Assisted doctors with Appeals reviews and informed patients'/families verbally and in writing of the decisions made.
NURSE CASE MANAGER
SIMONE HOME HEALTH CARE-Columbus, Ohio
March 2010 to March 2011
Developed patient care plans, including assessments, evaluations and nursing diagnoses.
Developed and implemented nursing care plans.
Documented patient information obtained from interviews.
Liaison between patients and physicians to ensure patient comprehension of treatment plans.
Effective counseling in health maintenance and disease management.
Followed infection control procedures.
Pharmacological and non-pharmacological management and treatment of various
disorders and diseases. Ensured efficacy of treatments through monitoring of treatment regimens.
Self-directed with astute judgment skills. High level of personal accountability
Ensured HIPAA compliance.
Answered/returned multiple phone calls daily, experienced with Microsoft Office products: Outlook, Word, Excel expert level, Access, Publisher, PowerPoint, familiar with.
DISEASE MANAGEMENT NURSE
ALERE INC-Worthington-Ohio
January 2008 to February 2010
Experience with various medical conditions including COPD, Diabetes, and Heart Failure
I was only 1 of 3 nurses cross trained and allowed to do all 3 types of clients.
Effective counseling in health maintenance and disease management by telephone, remotely monitoring daily weights, reviewing their dietary restrictions and educating them on the need to follow the restrictions and why it is necessary.
Pharmacological and non-pharmacological management and treatment of the disorders and diseases ordered by the physicians.
Answered/returned multiple phone calls daily, experienced with Microsoft Office products: Outlook, Word, Excel expert level, Access, Publisher, PowerPoint, familiar with.
CLAIMS REVIEW NURSE/NURSE CASE MANAGER
CIGNA HEALTHCARE-Columbus-Ohio
June 2004 to January 2008
Experience in reviewing written appeals as well as verbal appeals.
Effective decision-making skills based on available information and our criteria.
Assisted doctors with Appeals reviews and informed patients/families verbally and in writing.
Ensured HIPAA compliance
RN CASE MANAGER AND SUPERVISOR
TOTAL HEALTH MANAGEMENT - West Jefferson, OH
March 2001 to June 2004
Skillfully developed departmental goals, objectives, standards of performance, policies and procedures, including job descriptions to allow us to become URAC accredited thereby meeting Managed Care Organization (MCO) mandates by the Ohio Bureau of Workman's Compensation (BWC).
Organized the department in accordance with administrative guidelines in order to provide specified nursing services to meet the legal, organizational, and medical staff guidelines.
Supervised and managed the daily activities of the clinical team consisting of nurses and support staff.
Recruited, hired trained and coached on average of 8 new physicians per year to allow me to bring the Workers' Compensation appeals process in house instead of using an outside vendor, saving thousands of dollars annually.
Answered/returned multiple phone calls daily, experienced with Microsoft Office products: Outlook, Word, Excel expert level, Access, Publisher, PowerPoint, familiar with.
EDUCATION
DIPLOMA IN NURSING
LUTHERAN MEDICAL CENTER SCHOOL OF NURSING - Cleveland, OH
August 1971 to June 1974
HIGH SCHOOL DIPLOMA
CLOVERLEAF SENIOR HIGH SCHOOL
GRADUATED JUNE 1971
SKILLS
Excellent computer skills especially Windows based software
Excellent active listening skills and telephone manners
Strong in medical terminology
No difficulty collecting the callers' demographics, provider, and clinical info, for authorization for covered medical services
I can listen on a headset and type into the computer while listening so immediate documentation of all calls
Multi-tasking various things depending on current needs
I can explain the role and function of the company and provide education and technical support to the members
ACTIVITIES
FOR THE PAST 23 YEARS MY HUSBAND AND I HAVE TAUGHT HUNTER EDUCATION
FOR (ODNR)THE OHIO DEPARTMENT OF NATURAL RESOURCES. INSTRUCTING 5,000 STUDENTS BETWEEN THE AGES OF 7 AND 91.
I HAVE BEEN THE CO-CHAIR FOR THE EAGLE SCOUT BOARDS OF REVIEW FOR THE SCIOTO VALLEY DISTRICT OF THE SIMON KENTON COUNCIL OF THE BOY SCOUTS OF AMERICA FOR 24 YEARS. I WAS ALSO THE ADVANCEMENT CHAIRPERSON FOR
OUR LOCAL TROOP UNIT 526 SPONSORED BY WALNUT HILL UNITED METHODIST CHURCH OF COLUMBUS OHIO.
I ALSO SERVED AS :
ROUNDTABLE COMMISSIONER
DISTRICT COMMISSIONER
I RECEIVED MULTIPLE AWARDS FOR MY SERVICE, INCLUDING THE SILVER BEAVER AWARD WHICH IS THE HIGHEST AWARD THAT MAY BE GIVEN BY THE LOCAL BOY SCOUT COUNCIL.
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