Utilization Review Customer Service

Corinna Baumgarten, LPN

918-***-**** *********@*******.***

Professional Summary: Dedicated nursing professional with 28 years of experience in providing compassionate patient care to individuals of all ages in the Medical/Surgical setting and three years’ experience working Emergency Department. I am proficient in cultivating positive relationships with patients, and their caregivers, as well as my co-workers. I hold a firm belief that teamwork is important in any job. I recently took the initiative to learn Utilization Review with Remote Learning Services. Have strong documentation skills and a firm grasp of compliance requirements. I have an extraordinarily strong work ethic and believe punctuality is essential. I have a genuine love for this type of work, and I have an eagerness to extend my experience to learning other aspects through utilization review. Skills:

Utilization Review Concurrent Reviews

Quality Chart Review Retroactive Review

Medical/Surgical Preauthorization

Rehabilitation/Geriatrics Attention to detail

Care Coordination EMR/EHR Various Systems

Admission Reviews Time Management

Appeals/Denials Mentor/Leadership

Managed Care Critical Thinking

Medicare/Medicaid Microsoft/Excel

Knowledge of Claims/Billing Excellent Customer Service Work History:

Licensed Practical Nurse-Medical/Surgical, Urgent Care/ED Drumright Regional Hospital April 2005- May 2022

Drumright, OK

● Review charts and interpret health care records while submitting data as ordered

● Complied with all company specific guidelines and HIPAA confidentiality

● Assess patient symptoms when coming to ED. Assist the ED provider in determining best course of action in caring for patients and help resolve the issue quickly

● Devote special emphasis to punctuality and work attendance ED/Licensed Practical Nurse and ER Tech

Stillwater Medical Center March 2014-June 2017

Stillwater, OK

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

● Demonstrated critical thinking skills in both emergency situations and daily care

● Worked with interdisciplinary team to provide patient-centered care. CNA/Unit Secretary/Telemetry/Licensed Practical Nurse-Medical/Surgical Unit Stillwater Medical Center October 1994-April 2005

Stillwater, OK

● Adapts to new environments and provides excellent care to patients.

● Conducted routine chart audits to ensure needed documentation. Professional Education:

Utilization Review-101, Remote Learning Services - Teachers: Judy Clark RN, Marie Peppers LPN Certification of Completion - 10/2022

Tulsa Community College Tulsa, OK 2002-2006

Completed all pre-requisites required for the RN Program including the LPN Bridge course Central Technology Center-Practical Nursing Drumright, OK 1999-Feb 2000 License: Licensed Practical Nurse, Oklahoma-Compact: L0043706- Current

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