Diligent nursing professional with demonstrated success in patient care. Agile and responsive to dynamic patient needs and environmental conditions. Team-oriented and reliable with expert healthcare knowledge, clear verbal and written communication skills and sound clinical judgment.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Register nurse – medical assistant
Cardiovascular & Vein Clinic of Puerto Rico
01.2022
Assisted physician with minor procedures in office
Proficient in obtaining medical history and vital signs, promptly recording data in EHR and documenting patient concerns during doctor evaluation
Under physician approval, verify patient pharmacy and medication to order refills.
Clinical investigator Analyst
Optum
09.2022 - Current
Investigate, review, and provide clinical and / or coding expertise in review of post - service, post payment claims, which requires interpretation of state and federal mandates, billing practices / patterns, applicable benefit language, medical and reimbursement policies, coding requirements and consideration of relevant clinical information on claims with overt billing patterns and make pay / deny or payment recommendation decisions based on findings.
Maintain and manage daily case review assignments, with a high emphasis on quality, with at least 95% accuracy and within client / guidelines and provides clinical explanation both to the provider.
Participate in training of new staff and serves as a clinical resource to other areas within the clinical investigative team and provides guidance and feedback to peers when applicable.
Register Nurse
La Clínica de Rinosinusitis
01.2017 - 01.2021
Assisted the doctor during minor surgeries and procedures
Provided patient and family pre-operative and post-operative education
Monitor and maintain inventory and supply levels; prepare and submit supply replenishment orders to maintain par levels
Record patients medical history, vital statistics, and test results in electronic and physical medical charts
Monitored new recruits in the team and trained them about the procedures perform in the office
Facilitated therapeutic communication to help patients have a successful post-operative recovery
Coordinate appointment for pre-admissions.
Register Nurse
Dr. Wagner gynecology and obstetrics office
01.2015 - 01.2017
Responsible for handing the doctor the right tools during each step in an office procedures
Expertise in providing monitoring vital signs
Record patient information obtained from interviews concerning symptoms, medications, and prior treatment.
Education
Master Degree Nurse educator -
National University College
Caguas
08.2023
Bachelor of Science in Nursing -
Colegio Universitario de San Juan
01.2016
Skills
Ability to maintain calm under stressful situations and strong endurance
Ability to work directly with patients, families, and doctors
Critical thinking and problem solving
Teamwork and dependability
Case Management
Inventory
Medical electronic records Management
Appointment Scheduling
Recording Patient Medical history
Patient Preparation
Equipment Sterilization
Experience with insurance authorizations
Microsoft Office
Certification
CPR Certified
Colegiación de Enfermería vigente
Languages
Spanish
English
Timeline
Clinical investigator Analyst
Optum
09.2022 - Current
Register nurse – medical assistant
Cardiovascular & Vein Clinic of Puerto Rico
01.2022
Register Nurse
La Clínica de Rinosinusitis
01.2017 - 01.2021
Register Nurse
Dr. Wagner gynecology and obstetrics office
01.2015 - 01.2017
Master Degree Nurse educator -
National University College
Bachelor of Science in Nursing -
Colegio Universitario de San Juan
CPR Certified
Colegiación de Enfermería vigente
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