Aracel Corvera

NCSU

• Gathered, reviewed, and organised clinical documentation from providers and facilities for submission to the utilisation team.
• Ensured completeness and accuracy of patient records including medical history, diagnostics and treatment plans.
• Communicated with case managers via phone and email to obtain missing or additional clinical information.

RUR Team

• Reveiwed and analyzed denied or question claim through resprospectived utilization reveiw.
• Evaluated clinical documentation to support appeals and reconsideration request in accordance with medical policies and plan.
• Prepared and submitted comprehensive appeal documentaion, including clinical summaries and supporting evidence.

Covid Project

• Schedule Covid 19 vaccination appointments for patient in accordance with eligibility guidance and vaccine availability.
• Coordinated with patient via phones, email or system platforms to confirm, reschedule or cancel appointments.
• Provided accurate infromation regarding vaccine and protocal, schedules (1st dose, 2nd dose and boosted) and clinic procedure

LifeLink

• Coordinated and facilitated medical consultaion by recieving and endorsing cases to appropriate specialist via phone and email
• Managed inbound and outbound communication with healthcare provider, hospitals and multidisciplinary teams to ensure timely patient care
• Arranged and coordinated patient transfers via ground and air ambulance.
• Activate and supported emergency response protocaol including trauma and stroke activation
• Prioritized urgent and critical cases, ensuring rapid escalation and appropriate level of care
• Maintain accurate and detailed documentation of all communication, patient status and care coordination activities.
• Ensured compliance with clinical protocols company policies and patient confidentiality standards

• Effectively communicate with customers through phone, email.
• Assist members in verifying insurance benefits to promote confidence in coverage and claims.
• Provide detailed information about claim inquiries.
• Provide quality and effective resolutions to customer complaints via phone and email.

• Conduct health screenings and assessments for employees to identify potential health risks.
• Provide first aid and emergency care for workplace injuries or sudden illnesses.
• Maintain confidential health records and document all employee injuries and illnesses.
• Develop and implement health and safety programs, including wellness initiatives, stress management, and preventive care.
• Monitor the work environment for hazards and recommend interventions to improve safety.

• Coordinated patient care in consultation with multidisciplinary team of health professionals.
• Actively promoted best nursing practices, leading by example in providing accurate, prompt patient provisions.
• Maintained a safe, clean, and comfortable environment for patients, adhering to infection-control policies.
• Measured blood pressure, pulse and temperature to assess and record vital signs.
• Administered oral, topical and intravenous medications based on patient symptomatology and treatment plans.
• Monitored, recorded, and reported symptoms or changes in patient conditions in a timely manner.
• Administered medications and treatments to patients following prescribed healthcare plans.
• Monitored patient conditions closely, reporting and recording signs of deterioration for swift action.
• Documented patient care services by charting in patient and department records accurately.
• Inspected, cleaned and dressed patient wounds for optimum healing.

• Educated patients and their families on disease prevention and health maintenance practices.
• Administered medications and treatments to patients following prescribed healthcare plans.
• Administered oral, topical and intravenous medications based on patient symptomatology and treatment plans.
• Monitored, recorded, and reported symptoms or changes in patient conditions in a timely manner.
• Measured blood pressure, pulse and temperature to assess and record vital signs.
• Inspected, cleaned and dressed patient wounds for optimum healing.
• Collaborated with multidisciplinary team members to plan and implement patient care plans effectively.