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Brittany
broberson0803@starkstate.net
561-234-6603
9505 Minorca Way Apt 108
Palm Bch Gdns, FL 33418
Utilization Review Specialist
11 years experience W2
0
Recommendations
Average rating
36
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Summary

1. Chemical Dependency 2. Utilization Review 3. Long-Term Care/ Acute Care 4. Home Health (Private Duty) 5. Electronic Medical Records experience. 6. Detox and 12-step experience 7. Community Health Nursing

Experience
Medical Devices
Nov 2015 - present
Utilization Review Specialist
  • Completes precertification with insurance companies based on information gathered during the initial evaluations of client.
  • Completes concurrent reviews with insurance companies to obtain authorization for continued services.
  • Works in coordination with the clinical staff, nursing department, admissions department, and medical director to gather information on client's chart.
  • Participates in educational activities.
  • Answers questions about insurance submittal process from clients, family members, staff members, and insurance companies
  • Identifies and resolves client complaints
  • Enters utilization review notes in client record
  • Maintains strict confidentiality adheres to all HIPAA and PA State guidelines and regulations
  • Maintain bill log for level of care for claims submissions
No skills were added
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Oct 2011 - Dec 2019
Private Duty Nursing (LPN) 1.
  • Perform total patient care for clients in their homes: including medications, personal hygiene, range of motion, and tube feedings, for 4-8 hours a day.
  • Determined needs in initial home visit evaluation and initiated beneficial changes including establishment of nursing care plans, a charting system to insure continuity of care, and development of comprehensive patient history for emergency hospitalizations.
  • Take a compassionate and pro-active approach to patient's care
  • Continually provide personal services to stimulate patient, and inform family as to care changes necessary as patient's condition changed
No skills were added
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Medical Devices
Jun 2014 - Nov 2015
Utilization Review Specialist
  • Completes precertification with insurance companies based on information gathered during the initial evaluations of client.
  • Completes concurrent reviews with insurance companies to obtain authorization for continued services.
  • Works in coordination with the clinical staff, nursing department, admissions department, and medical director to gather information on client's chart.
  • Participates in educational activities.
  • Answers questions about insurance submittal process from clients, family members, staff members, and insurance companies
  • Identifies and resolves client complaints
  • Enters utilization review notes in client record
  • Maintains strict confidentiality adheres to all HIPAA and PA State guidelines and regulations
  • Maintain bill log for level of care for claims submissions
No skills were added
Remove Skill
Medical Devices
Oct 2013 - Jun 2014
LPN, Utilization Review Specialist
  • Day nursing care and coverage
  • Completion of Nursing/Health Assessments with new admissions
  • Alerting the MD or PA of significant client issues or changes in condition
  • Ensuring strict client confidentiality is maintained in accordance with facility and HIPAA regulations
  • Medication Administration Record (MOR) documentation and maintenance
  • Utilization Review
  • Ensuring strict client confidentiality is maintained in accordance with facility and HIPAA regulations
  • Inventory and ordering of medical supplies/equipment
No skills were added
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Aug 2012 - Nov 2013
Skilled nursing care as ordered on the
  • Assessing and reporting in an accurate, concise and professional manner
  • Observes aseptic techniques as required
  • Performs specific treatments and administers medications as ordered
  • Educates patients and significant others regarding the patient's illness, procedures, treatments, including self-care, prevention, and health maintenance
  • Documents all changes in patient's physical or psychosocial condition
  • Keep supervisor and staff advised of changes in patient's condition
  • Documents and notifies staff changes in patient's medications, treatments, etc.
  • Provides discharge instructions to patient and family
No skills were added
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LPN
Medical Devices
Jul 2013 - Oct 2013
1.
  • Day nursing care and coverage
  • Completion of Nursing/Health Assessments with new admissions
  • Alerting the MD or ARNP on-call of significant client issues or changes in condition
  • Ensuring strict client confidentiality is maintained in accordance with facility and HIPAA regulations
  • Medication Observation Record (MOR) documentation and maintenance
  • Observation and documentation of client medication self-administration
  • Arranging for any ancillary medical services or testing necessary for client care
  • Transcription of medical orders
No skills were added
Remove Skill
LPN
Nov 2011 - Oct 2012
1.
  • Coordinating health screenings
  • Assisting with the prevention and control of communicable disease
  • Assisting with the monitoring and implementation of immunizations requirements
  • Assisting with the monitoring of physical exam requirements
  • Participating in health in-services to assist in the identification of children with health concerns
  • Attending workshops/trainings to update skills and acquire additional technical knowledge
  • Cooperating with other agencies to coordinate services
No skills were added
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Nurse Supervisor (LPN)
Medical Devices
Mar 2010 - Jan 2011
  • Provides basic bedside care
  • Measures & records patients' vital signs (such as height, weight, temperature, blood pressure, pulse, respiration)
  • Prepares and gives injections and enemas
  • Monitors catheters
  • Records food/fluid input/output
  • Dresses wounds
  • Prepares and administers (orally, subcutaneously, through an IV) and records prescribed medications
  • Administration of medications
  • Assists in relevant health teaching for patient and family/significant other
Catheter Nursing
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Edit Skills
Non-cloudteam Skill
Education
Practical Nursing
Brown Mackie College 2009
Certifications
Licensed Practical Nursing License (Florida) (PN5203284)
Peripheral IV Certification
Cardiopulmonary Resuscitation (BLS)
CPI Training
Skills
Catheter
2011
1
Nursing
2011
1
Home Health
0
1
Utilization Review
0
1