NICOLE NOA BELTRÁN
Toa Alta,Puerto Rico
Summary
Skilled Clinical Review Nurse with background in evaluating patient care and developing effective treatment plans. Strengths include knowledge of healthcare regulations, clinical documentation, and medical coding, with focus on improving efficiency and ensuring compliance. Previous work has shown significant impact in enhancing patient satisfaction while maintaining strict adherence to healthcare guidelines and protocols.
Overview
3
3
years of professional experience
1
1
Certification
Work History
CPC RN Clinical Reviewer
OPTUM
San Juan, Puerto Rico
07.2024 - Current
- Conduct clinical reviews of professional and facility claims to determine claim validity based on medical records and regulatory guidelines.
- Ensure accuracy and compliance with state and federal policies while optimizing data integrity and process efficiency.
- Investigate and resolve claim discrepancies, provide clear clinical rationale to providers, and collaborate with internal teams to enhance operational effectiveness.
President & Social Media Coordinator
#Adulting PR
01.2022 - Current
- Company Overview: An organization to help out university and young professionals giving tips and showing them the value of helping our community especially those in need
- An organization to help out university and young professionals giving tips and showing them the value of helping our community especially those in need
Seasonal Vaccination Nurse and Clinical Nurse
Walgreens
San Juan
09.2023 - 01.2024
- 5 month contract nurse that was responsible for preparing and administering different types of vaccine shots, educating patients on the importance of vaccination, and maintaining accurate records of all vaccinations given during the highest flu season
COVID-19 Vaccination Nurse and Clinical Nurse
Universal Insurance (Universidad Universal)
09.2022 - 09.2023
- Provided the safe administration of the COVID-19 vaccine to the community and had primary duties
- Dedicated Doctors Office Nurse with experience working within various medical office settings (Attending patients of Dermatologist, Generalist, Quiropractor, and many other specialties)
Education
Bachelor of Science - BSN Nursing
Universidad Interamericana de P.R
San Juan01.2021
Skills
- Leadership
- Customer Service
- Microsoft 360
- Medication Prep
- Vital Signs & Medical
- Electronic Record
- Problem Solving
- Patient Education
- Clinical review
- Patient education
- Critical thinking
- Time management
- Organizational skills
Certification
- BSL
- ACLS
- Phlebotomy, IV Access and Dose Calculation
- IV Therapy
Volunteer Experience
- Volunteer Teacher, AIC (Asociación de Intercambio Cultural), Had the opportunity to participate as an English teacher in an educational trip with a group of girls between the ages of 8 to 18 residing in Kazakhstan. Activities Coordinator English course in a dynamic with workshops, cooking classes, and games were given as an alternative to help in the development of speaking English in a fun and efficient way!, 2018
- Volunteer Activities Coordinator, Como Otro Yo, Coordinated and participated in community service activities that included: feeding the homeless, visiting the most needed, painting murals, and amongst many things that would help different communities., 2018
Languages
Spanish
First Language
English
Proficient
C2
Timeline
CPC RN Clinical Reviewer
OPTUM
07.2024 - Current
Seasonal Vaccination Nurse and Clinical Nurse
Walgreens
09.2023 - 01.2024
COVID-19 Vaccination Nurse and Clinical Nurse
Universal Insurance (Universidad Universal)
09.2022 - 09.2023
President & Social Media Coordinator
#Adulting PR
01.2022 - Current
Bachelor of Science - BSN Nursing
Universidad Interamericana de P.R