Audrey Buckley Email & Phone Number

Goal oriented RN, with current Florida RN license and varied skills and experience in multiple areas of the medical field. Areas of work experience include but are not limited to: Quality Improvement, Claims/ Appeals Processing, Review and Preparation of Legal Cases, NCQA submission, HEDIS, Use of the ICD 9 Diagnosis codes, CPT -4 procedure coding and HCPC coding. Experience with Word, Excel and Access, training in Power Point, knowledge of HIPPA and ERISA regulatory requirements, Medical Audits/ Focused review studies/ Special projects, Writing articles for Patients, Facilities and Physician Updates. Re-wrote the Utilization Management Program Description for NCQA accreditation, and UM 1, 2 and 3 for submission to NCQA. Worked to create, print and provide to Physicians, a tool to enable them to improve their documentation of a consistently low scoring indicator. Experience in Hospital contract interpretations, Instructor in Emergency Nursing at a college level, Call Center experience of greater than 1 year, authorizing all after hours emergency admissions for a major health plan from the hours of 4 PM – 12 Midnight, Medical /Surgical/ Emergency Department/ICU/CCU hospital experience, Worked on the cardiac arrest team and trauma team, Home Health Experience as both a visiting nurse and nursing supervisor . Interest in all of the previous and employment in those areas. Interest in obtaining information for Pre Admissions and Pre Surgical Patients and follow-up on discharged patients.Specialties: Quality ImprovementReview of Legal CasesReview of Claims/Appeals/DenialsInterest in follow-up on discharged patients

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  Nova Southeastern U. And Miami Dade College

  Nursing