Registered Nurse Medical
Resume:
Judy Mayes, RN, BSN
Charlotte, NC 28277
***********@*****.***
SUMMARY
Registered Nurse with solid background and education in medical case management, administration and managing workers' compensation administrative staff. Experienced in occupational health.
QUALIFICATIONS
• Extensive knowledge and experience in the rehab and administrative fields
• 16 years working in a workers' comp claims office in various capacities
• Attention to details and multi-tasking skills
• Occupation health nursing experience at Philip Morris, USA and ICI Americas from 1980 to 1987. Synopsis of job duties include treating occupational injuries and non-occupational illnesses, administering tetanus injections, drawing blood samples, audiometric, EKG and pulmonary function testing, cholinesterase & blood pressure screening, TB testing, member of Safety Team.
ACHIEVEMENTS
• Relocated to Charlotte from Louisville, KY and assisted in successfully opening and establishing the AIG office in 1996
• Successfully setup and managed the Medical Management Unit until the company created an Operations Center in Alpharetta, GA
• Received Meritorious Service Award along with my staff for auditing and paying medical bills timely and cost savings through bill review
WORK EXPERIENCE
2004-2010 AIG
Administrative Manager Charlotte, NC
Managed claims assistants and mailroom staffs, file FROIs via EDI, completed and filed
forms required by NC & SC commissions, maintained office equipment inventory, reviewed
security reports and performed operational self audits, maintained Business Continuity
Plan, hired employees, serve as liaison for maintenance service providers, issued and
De-activated security card keys, obtained claims reports via online system.
1998-2004 AIG
Manager/Nurse Reviewer Charlotte, NC
Managed Provider Bill Review Unit and mailroom, ensured medical bill data entered and adjudicated properly and timely, also responsible for timely payment of medical bills, managed the processing of incoming and outgoing mail, reviewed hospital and surgical bills for proper billing codes, reviewed operative reports for proper billing practices, reviewed and processed or denied provider reconsideration appeals.
1996-1998 AIG
Manager, Medical Management Unit Charlotte, NC
Hired and supervised contracted Nurse Case Managers, reviewed and submitted their reports and timesheets, ensured that medical bill data entered and adjudicated properly and timely, also responsible for timely payment of medical bills.
1994-1996 Nurse Consultant AIG
Louisville, KY
Served as resource for adjusters relative to the medical management of workers' compensation claims, reviewed claims and advised as to the appropriateness of medical treatment, recommended physicians for and schedule IMEs, supervised contracted Nurse Case Managers, reviewed and submitted their reports.
1990-1994
Rehabilitation Nurse Recovery Unlimited
Louisville, KY
Coordinated medical care of injured workers, attended physician appointment to obtain information regarding treatment plans, expected length of treatment and disability, RTW dates,PPI ratings, performed job evaluations, consulted with employers for the availability of restricted or modified duty, maintained communication with injured workers and composed and submitted reports to adjusters, scheduled and attended IMEs and enrolled injured workers in physical therapy and pain management facilities.
EDUCATION Louisville, KY
1979 Spalding College
Bachelors of Science in Nursing
NC Registered Nurse License
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