Licensed Philippine Registered Nurse (August 2009) and U.S. Registered Nurse (July 2023) with over 16 years of healthcare experience, including 13 years in hospital-based nursing and 3.5 years in Clinical Audit and Utilization Management. Certified Risk Adjustment HCC Coder (February 2024) with expertise in risk adjustment coding, clinical documentation review, utilization management, compliance, and healthcare quality improvement. Knowledgeable in MDS assessments, ICD-10-CM coding, RAI Manual guidelines, PDPM reimbursement methodology, medical revenue codes, and claims review processes. Recognized for strong clinical judgment, analytical skills, attention to detail, and commitment to delivering high-quality patient care and operational excellence.
Experience: 5 - 10 years
Has worked as a Utilizations Nurse Reviewer for Health Insurance approvals and claims
Experience: 5 - 10 years
Has worked as a Utilizations Nurse Reviewer for Health Insurance approvals and claims; Has knowledge in HIPAA
Experience: 5 - 10 years
Can converse in English with above average knowledge in medical terms
Experience: 5 - 10 years
Experience: 5 - 10 years
Has been assigned as assistant supervisor in the Neonatal Intensive care unit for 5 years
Experience: 5 - 10 years
Experience: 5 - 10 years
Above average ability to transcribe data analysis in call in terms of medical field
“I had this VA that I could turn things over to made it a lot easier”
Kyle Mckenna
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