I worked as an ER nurse for about 7 years. I handle In patient admission, IV insertion, medications and other related matters.
I'm A US RN, License in Illinois. I worked as a clinical nurse reviewer for almost 3 years. I review In patient Length of stay and out patient procedures such as Surgical procedures, bariatric surgery, drug/Medical Oncology and Radiation Therapy. Our client was Anthem Blue cross. I covered Local California, National, NY, Kentucky, Local Central.
I also do insurance verification, Checking if procedure is covered by the insurance. I check the Policy bought by the Patient. Additionally I Check for authorization or prior denials In ACMP or Anthem Care Management Platform, Claim History and Medical records.
