Registered Nurse Customer Service

Marian L. Torrez, BSN RN

***** ** ***** **., ****, WA 98042

971-***-****; ********@*****.***

OBJECTIVE

Seeking a position with an acute care medical center where I would be able to utilize my strong organizational, interpersonal and communication, and registered nursing skills. I also wish to be able to use my lifelong bi-lingual Spanish-English ability to assist with the care of under-served minorities.

WORK EXPERIENCE

June 2011 – Present Careforce Lynnwood, WA

Home Health RN

Duties: Home health nursing care that includes comprehensive patient evaluations, performing procedures such as IV placement, phlebotomy, and medication therapy. Provide hands-on personal care, assistance in ambulation or exercises. Prepare clinical and progress notes, coordinates services, inform the physician and other personnel of changes in the patient's condition and needs, counsel the patient and family in meeting nursing and related needs, and participate in all in-service programs.

August 2009 –December 2010 Guidance Staffing Seattle, WA

Claims Examiner

Duties: Review Pension plan to determine if claim is covered; process claims according to individual policy specifications; perform computations; processes benefits correctly on claims to a dollar amount as directed by the Trainer, Lead or Assistant Manager- not to exceed $2,500.00. Maintain a 10 day turn around time on assigned claims, provide ongoing communication and customer service with providers, members, insurance carriers and other eligible parties on various matters concerning claims.

August 2006 - June 2009

Full time BSN nursing student

September 2000 – September 2006 Standard Insurance Company Portland, OR

Sr. Disability Examiner

Duties: Analyze and processes complex claims by investigating and gathering information to determine the exposure on the claim. Assesses liability and resolve claims within evaluation. Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout the life of the claim. Calculates and pays benefits due; approves/makes timely claim payments and adjustments. Prepares necessary state filings within statutory limits. Manages the litigation process; ensures timely and cost effective claims resolution. Ensures claim files are properly documented and claims coding is correct. Completion of The Standard Insurance Company Long Term and Short Term Claims Examiner Training Program.

EDUCATION

Double BSN from University of Turabo, Puerto Rico, US (CCNE accreditation) and the International University of Nursing in St. Kitts/Nevis, West Indies (Caribbean and Commonwealth Countries accreditation)

May 2008 - June 2009 University of Turabo Gurabo, PR

Bachelor of Science in Nursing, 2009

Award for Most Improved Student

Clinical Experiences: ICU, Med/Surg Unit and Emergency Department at San Juan VA Medical Center, and at Hospital General Menonita de Cayey.

August 2006 – April/June 2009 International University of Nursing Basseterre, St. Kitts

Bachelor of Science in Nursing, 2009

Clinical Experience: HIV/AIDS certified counselor; developed country’s first blood drive as part of the Student Nurses’ Association; Women’s Health Initiative in 5 participating factories; long-term care at The Grange Nursing & Home Health Services; acute care at Joseph N France General Hospital.; home care on the island.

LICENSES & CERTIFICATION

Louisiana State Registered Nurse # 133273 Washington State Registered Nurse # 60236805

State of Alaska Registered Nurse # 33538

TNCC/BLS/CPR/AED Certified Certified Hatha Yoga Instructor, Yoga Alliance

Master-Case Management degree- in progress

SKILLS

Proficient in speaking, reading and writing in Spanish;

Detailed understanding of billing and coding and claims based care;

Strong organizational, time management and problem resolution skills;

Claims research, analysis and accounting abilities.

Contact this candidate