Data Entry Review Nurse

Marva Valentine-Baksh

Professional Summary: Licensed Practical Nurse/LPN II

Highly Skilled Career Professional with more than 30 years practical experience in Hospital; Clinics; Doctors O ce; Home Health; Health/Disability Insurances and Primary Care environments.

Remote NICU Medical Records Nurse Reviewer and Nurse Auditor/Paymaster for UnitedHealthCare Insurance Company.

Clinical Sta Nurse for Outpatient,multi speciality clinic for MD’s With duties to include Assessments, Counseling, Education in regards To medications and treatments; Diabetic Case management; lab work; Documentation with Care Plan for diagnosis and administration of Treatment procedures.

Hedis Reviewer for MD’s practices, clinics and Long Term Care Facilities. Obtaining and reviewing confidential medical records for Medical Compliance To Hedis measures and Standards.

Assignments with various health insurances and HMO organizations/companies as a Concurrent Reviewer nurse; telephonic case manager; telephonic case manager; utilization reviewer and Precertification, referral and telephonic nurse.

Disability Case manager to include assessments, counseling; education in Regarding medications and treatment plans.

Quality Assurance/Disease Management reviewer; discharge planning; Medicaid/Medicare of Florida referral coordinator.

Computer skilled, managing heavy daily patient volumes to include Telephonic triage;appointment scheduling and patient referrals. Proficient in all documentation/medical records maintenance, Paperwork to ensure accuracy and patient confidentiality.

Medical Records Supervisor, utilizing numerical,alphabetical and Chronological filing systems.

Coded all authorizations approved with ICD-9/CPT codes per diagnosis And treatment procedures to ensure proper payment when bills are submitted to payer source.

Examined/ Reviewed and paid claims vouchers forwarded to the Insurance carriers based on standard rates and computer fee schedules.

Sta Nurse/LPN II responsible for delivery of direct patient care to Newborn infants, post delivery and on admission to Newborn Nursery. Assisted Neonatologist in OR with deliveries and C Sections, monitoring newborns well being at time of delivery.

Credentials:

State Board Examinations-1984 Licensed State of Florida–1984

6611 Salem

North Lauderdale,Florida 954-***-****

754-***-**** adu7x4@r.postjobfree.com m

Remote NICU Reviewer/Nurse Auditor UnitedHealthCare of Florida

Clinical/O ce Nurse

Sylvester Comprehensive Cancer Clinic and Spine Center

Hedis Reviewer

All Medical Personnel/Vista Health Plan

Concurrent review Nurse/Hospital Reviewer All Medical Personnel/BCBS of Florida

Disability Case Management

All Medical Personnel/Physicians Health Care

Diabetic Case Management

All Medical Personnel/Principal HealthCare

Front Desk Coordinator

SFlorida OB/Gyn O ce/Dr.Winston Alexis

Medical Records Supervisor

Comprehensive Community Health Ctr./Dr. R Moise

Referral/Intake Coordinator

Linda Robbins Employment Agency/Principal Health Care

Intake Coordinator/Insurance Verification/sta Nurse Pediatrics Services Of America/Kids Medical Personnel

Sta Nurse/Sta Relief/PerDiem/LPN/

Specialty Newborn Nursery/LPN II/Westside Regional Hospital/Memorial Hospital/Pembroke Pines Hospital

Reference: Neysa Young

Stacy Brown

Everlin Priestly :

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954-***-**** 954-***-**** 786-***-****

Dec.2007-2010 6/2007-11/2007

3/2007-6/2007 1/2007-3/2007 11/2006-1/2007

1/2002-6/2002 12/2001-6/2002 1/2001-12/2001

1/1999-1/2001 1/1994-12/1996

12/1985-1/1994

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