Miracle April Kildoyle
Registered Nurse
Vallejo, California
Summary
Dedicated and highly motivated Registered Nurse, licensed in California and New York, with extensive experience in direct patient care and clinical review. Progressed from a staff nurse role, acquiring hands-on expertise in patient assessment, medication administration, and bedside care. Currently serves as a Clinical Appeals Nurse, utilizing clinical knowledge to assess medical necessity, ensure appropriate utilization of healthcare services, and support appeals processes in accordance with regulatory guidelines. Possesses a strong understanding of clinical documentation, insurance protocols, and interdisciplinary communication while remaining committed to delivering high-quality, patient-centered care.
Overview
2026
2026
years of professional experience
5
5
Certifications
Work History
Appeals Nurse– Clinical review
Elevance Health / Carelon Global Solution
2024 - Current
- Analyzing insurance claim denials or coverage for medical treatments or procedures at a healthcare facility.
- Conducts comprehensive reviews of utilization data, including claims, authorizations, and medical records.
Staff Nurse– Infection control
Tanza Specialist Medical Center
- Preventing and managing healthcare-associated infections within healthcare settings.
- Monitor the patient’s condition and evaluate their needs to provide the best possible care.
Education
Bachelor of Science - Nursing
Arellano University– Andres Bonifacio Campus
01.2023
Skills
Patient education
Medication and IV administration
Direct patient care
Medication administration
Care plan implementation
Patient assessment
Patient care
Patient management
Infection control
Licensed RN
Clinical documentation
Certification
Registered Nurse – Board Certified
References
John Raymond, Suguitan, RN, Email: suguitangio@gmail.com, Position: Prior Authorization Nurse– Cognizant
RELEVANT ACHIEVEMENTS
Dean’s Lister for 3 consecutive years.
Timeline
Staff Nurse– Infection control
Tanza Specialist Medical Center
Appeals Nurse– Clinical review
Elevance Health / Carelon Global Solution
2024 - Current
Bachelor of Science - Nursing
Arellano University– Andres Bonifacio Campus