RENISHA NORONHA

***** ** ******** **, ***** PLAINS, OR - 97133

206-***-**** - adz0vu@r.postjobfree.com

SUMMARY:

Senior Process Executive - data/healthcare with 3 years of experience at Cognizant Technology Solutions. Reviewed physical therapy, occupational therapy and chiropractic therapy claims.

Registered Nurse (India) with 3 years of experience in post operative ICU specialty. Skilled in technical procedures with a strong emphasis on patient assessment, assisting physicians with procedures, and excellent nursing care. Successful in prioritizing tasks, delivering acute care, and exercising sound judgment. Excellent communicator and strong patient advocate.

Education:

Bachelor of Science in Nursing at Fr. Muller College of Nursing, Mangalore, India from 2007-2011

Experience:

SPE - Medical Claim Analyst for Aetna at Cognizant Technology Solutions from April 2015-April 2018.

Accurately analyze the medical information to make medical necessity as per the organizational policy and procedures.

Review structured clinical data matching against specified medical terms and diagnosis or procedure codes and follow established procedures for authorizing request or referring request for further review.

Maintain patient confidentiality as defined by state, federal and company regulations.

Establish effective rapport with other employees, professional support service staff and customers.

Exceptional knowledge of medical terminology.

Review physician documentation and medical records to determine if proposed treatment plan and issue authorization letters.

Staff Nurse at Kasturba Hospital, Manipal, India from December 2012- December 2014

Provided direct quality care to post-operative patients for both scheduled and emergent surgeries.

Assessed patient's condition and monitored post-surgical recovery.

Implemented post-surgical treatment plan and provided detailed report to med/surg nurse for patient transfer/admission.

Reviewed and implemented physician orders.

Assisted in transesophageal echocardiogram procedures.

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