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Adale Vanpelt is listed as Registered Nurse Liasion at eviCore healthcare, a company with 2180 employees, based in Palm Bay, Florida, United States. AeroLeads shows a matched LinkedIn profile for Adale Vanpelt.
Adale Vanpelt previously worked as Clinical Liaison at Evicore Healthcare and Utilization Review Nurse at Evicore Healthcare. Adale Vanpelt holds Bachelor'S Degree, Health/Health Care Administration/Management from Capella University.
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Adale Vanpelt, RN 321-543-8898Adalevanpelt@gmail.comUtilization Liaison Registered Nurse skilled in high quality Healthcare and Utilization Management. Competencies:Utilization Management and Review, Appeals, Claims Review, Auditing, Managed Care, Documentation Review, Guideline expertise in Medicare, InterQual and Milliman Criteria, Data Analysis, Chart Abstraction, Medication Reconciliation Review, CPT and ICD 10 codes, Critical Thinking, Nursing skills: Med Surg, Pulmonology, Sleep Medicine, Oncology, LTC, Home Care, MS Office, EMR / EHR expertise with Medi Tech, Cerner, Athena and EPIC, Communication and Collaboration.Experience:Utilization Appeal Nurse Liasion • Utilization review for concurrent and retrospective reviews, claims, fair hearings and appeals• Monitor cases for compliance regulations including CPT codes, ICD 9/10 codes and turn-around times• InterQual, Medicare / Medicaid Guideline Interpretation • Maintain effective written and verbal communication• Perform quality chart and audits for accuracy• Prepare documentation and appeal letters for justification of medical necessity. Analyze for concurrent review, retrospective reviews, claims and appeals• Collaboration with Medical Directors, Health Plans and Providers to determine medical necessity and coverage indications through the prior authorizations03/24 – current
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Utilization ReviewChart Review / Documentation ReviewCoaching / Mentoring / Team BuildingLeadership and conflict managementMaintain and collaborate business relationshipsMedical Necessity, Appeals, Medical NecessityUtilization Management including concurrent and retrospective reviewsRead and interpret clinical informationPerform quality assessments and.
Melbourne, Florida, United States
Authorization review for concurrent and retrospective reviews, DME, imaging and proceduresChart Review, Documentation ReviewRead and interpret clinical informationCollaboration with Medical DirectorsRegistration, Insurance Verification, Medical NecessityPerform quality assessment and audits, Peer to Peers, AppealsInterQual and Medicare / Medicaid Guideline.
Melbourne, Florida, United States
Patient Advocacy and SupportPerform Patient Assessment & Vital SignsMedication Administration, Injections, Breathing TreatmentsWound Management, Trach/Vent Care, IV TherapyCharting/Record Management and HIPAA CompliancePhone Triage and Patient Education
Viera East, Florida, United States
Patient Advocacy and SupportPerform Patient Assessment & Vital SignsMedication Administration, Injections, Breathing TreatmentsWound Management, Trach/Vent Care, IV TherapyCharting/Record Management and HIPAA CompliancePhone Triage and Patient Education
Other employees you can reach at evicore.com. View company contacts for 2180 employees →
Laura Blaine, Mha
Colleague at Evicore Healthcare
Columbus, Ohio, United States, United States
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KC
Kierston Campos
Colleague at Evicore Healthcare
Nashville Metropolitan Area, United States
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OJ
Olivia Juarez
Colleague at Evicore Healthcare
San Antonio, Texas, United States, United States
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BP
Bridgette Polcha
Colleague at Evicore Healthcare
Melbourne, Florida, United States, United States
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MC
Michelle Chu
Colleague at Evicore Healthcare
Palm Bay, Florida, United States, United States
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KH
Kristen Horton
Colleague at Evicore Healthcare
Novi, Michigan, United States, United States
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BO
Briana Oliver
Colleague at Evicore Healthcare
Savannah, Georgia, United States, United States
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KL
Kimberly Lebron-Smith
Colleague at Evicore Healthcare
Clarksville, Tennessee, United States, United States
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TD
Tammy Driscoll
Colleague at Evicore Healthcare
Greater Colorado Springs Area, United States
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JW
Jocelyn Works
Colleague at Evicore Healthcare
Greater Colorado Springs Area, United States
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Quick answers generated from the profile data available on this page.
Adale Vanpelt works for eviCore healthcare.
Adale Vanpelt is listed as Registered Nurse Liasion at eviCore healthcare.
Adale Vanpelt is based in Palm Bay, Florida, United States while working with eviCore healthcare.
Adale Vanpelt has worked for Evicore Healthcare, American In-Home Care, Llc, Health First Medical Group, and Steward Health Care.
Adale Vanpelt's colleagues at eviCore healthcare include Laura Blaine, Mha, Kierston Campos, Olivia Juarez, Bridgette Polcha, and Michelle Chu.
You can use AeroLeads to view verified contact signals for Adale Vanpelt at eviCore healthcare, including work email, phone, and LinkedIn data when available.
Adale Vanpelt holds Bachelor'S Degree, Health/Health Care Administration/Management from Capella University.
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