I have all my information in my resume- I just need it to look professional. I did not add my name nor my phone number nor my email which I will do it later once the resume is completed.
Please fix my resume add a cover letter and a thank you letter.
the resume is as follow:
E-mail: • my email
Mobile: complete phone number
Clinical Nurse Audit specialist :Legacy health care Oct 2016-Present
Conducts coding audits, quality assurance assessments of claims, reviews
Statistical samples and analyze for risk.
Ability to apply expertise to ensure compliance with medical policy, medical necessity guidelines and accepted standards of care.
Conducts audits and uses nursing expertise to determine if claims will need to be reviewed
Understands and analyzes complex provider and hospital contracts
Ensures that medical claims, medical records and other documentation essential to proper billing is in compliance with federal regulation, company policies and industry standards
Develops written audit finding with respect to contractual compliance, recommendations for improved contracts, and other matters identified during the audit.
Extensive knowledge with the audit / Appeal process for CMS:MAC-ZPIC-OIG-RAC-UPIC and all managed care insurances.
Quarterly and as needed Lawyer meeting regarding the progress of the CMS audit.
GROVE of Northbrook nursing and rehab /chalet nursing and rehab
Restorative nurse /MDS coordinator /nurse supervisor August 2014-Oct 2016
Manages the Restorative Therapy Department and leads the Resident Safety Program in concert with State and Federal regulations .
Plans, develops, organizes, implements, evaluates and directs restorative therapy services for long-term care residents.
Educates facility staff in restorative therapy and its execution in a 24-hour per day operation.
Maintains complete and accurate records of therapy service assessments and services.
Coordinates restorative therapy services with therapy service provider to provide transitional services to facility residents.
Attends care plan conferences.
Plans, develops, organizes, implements, evaluates and directs the Resident Safety Program in accordance with the Illinois Department of Public Health regulations and facility standards.
Serves as the resident safety program coordinator, leading fall prevention, restraint reduction in accordance with State and Federal guidelines.
Prepares and presents regular reports on the Resident Safety Program; reports monthly to the Quality Assurance Committee. Educates facility staff, residents and families regarding resident safety.
Directly supervises employees within the Restorative Therapy Department. May supervise additional employees as needed
MDS/Care Plan Coordinator
Conduct initial and periodic comprehensive, accurate and standardized assessment of each resident in the facility.
Develop and maintain a schedule system to ensure all assessments and care plans are conducted in accordance with guidelines set forth by governmental agencies.
Perform quarterly assessment review and perform revisions as appropriate per each resident condition.
Lead interdisciplinary team to develop a comprehensive care plan for each resident, which shall include measurable objectives and time-tables to meet resident’s medical, nursing, mental and psychological well-being.
Required to check weights on weekly and monthly schedule.
NORRIDGE GARDENS NURSING AND REHAB : DEC 2013-august2014
RESTORATIVE NURSE MANAGER
Grove North Nursing and Rehab Center March 2012 – November 2013
Certified Restorative Nurse Manager
Community Care, LLC : Dec 2011 – May 2012
Licensed Practical Nurse – floor nurse Renal/Adult Med Surg Units
Administered medications, maintained NGT tubes with safety checks.
Patient assessments, bed baths, colostomy care.
Isolation precautions, fingersticks for DM ,vital signs.
Peg tubes, Post-op care, specimens, sub-Q, IM injections.
Trach suctioning and nebulizer treatments, oral care
Report any abnormal lab to the physician
Education, Training & Certification