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@examworks-cs.com
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5 phones found area 630, 800, and 949
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LinkedIn matched
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Denise Burns, Rn, Ccm is listed as Medical Care Evaluator Writer at Gould and Lamb LLC at Gould & Lamb, LLC, a with 196 employees, based in Aurora, Illinois, United States. AeroLeads shows a work email signal at examworks-cs.com, phone signal with area code 630, 800, 949, and a matched LinkedIn profile for Denise Burns, Rn, Ccm.
Denise Burns, Rn, Ccm previously worked as Medical Care Evaluator Writer at Gould & Lamb, Llc and Software Engineer at The Trizetto Group. Denise Burns, Rn, Ccm holds .Net Developer Certificate from Depaul University.
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AeroLeads found 1 current-domain work email signal for Denise Burns, Rn, Ccm. Compare company email patterns before reaching out.
Certified Case Manager with extensive background in catastrophic, medical, workers' compensation and transplant case management, telephonic and onsite. Clinical expertise in NICU, telemetry, HHC and rehabilitation with strong negotiation skills. Current Illinois RN license.Specialties: License: RN License, State of IllinoisCertified Case Manager (CCM) 1993, 1998, 2003, 2008
Listed skills include Healthcare, Hipaa, Technical Writing, and Health Insurance.
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A career timeline built from the work history available for this profile.
Projecting future medical care and treatment in an organized narrative format, utilizing clinical evidence and medical research.- Analyze claims payment and medication listings- Review, understand and summarize medical records - Create an accurate historical narrative based on medical records - Determine future care needs of claim and include in narrative
- Acted as liaison between clients and Network facilities.- Interpreted global network contract.- Coordinated case management services for clients.- Provided computer / systems support for staff.- Conducted orientation of new clients / reorientation of existing clients.- Participated in computer user group committee.
-Determined medical necessity and member eligibility to receive an organ transplant based on medical documentation received.-Communicated with staff at transplant facilities and plan members to work through the transplant process.-Verified eligibility information and conducted research in order to educate members on their benefits.-Conducted clinical reviews of members.-Communicated with members to help them navigate information, to explain benefits that were available to them, as well as medication, costs, lifetime adherence and treatment compliance..-Followed up with member and facility during entire process.-Maintained confidentiality of sensitive and protected health information.-Consulted with Physician as needed to determine eligibility for transplant.
Ensured timely claims payment, maintained provider file, reviewed high dollar claims and evaluated system needs for claims business.- Analyzed claims system to ensure meeting company needs.- Recommended system changes from few edits to more strict edits.- Evaluated system changes for data integrity.- Utilized CICS system as well as an AS/400 system.
Provide comprehensive case management service including treatment recommendation, negotiations of healthcare services and client / customer service.- Specifically requested by client companies to manager theiremployees worker compensation benefits.- Provided training on negotiations / cost effectiveness to peers.
- Negotiated healthcare costs with providers.- Arranged cost effective care for critically ill patients.- Provided monthly reports to Department of Defense / CHAMPUS on cost effectiveness of care.
Other employees you can reach at examworkscompliance.com. View company contacts for 196 employees →
Tom Power
Colleague at Gould & Lamb, LlcFlowery Branch, Georgia, United States
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KZ
Kerry Zelanka
Colleague at Gould & Lamb, LlcGarden City, New York, United States
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Andrea Gratopp
Colleague at Gould & Lamb, LlcSpicewood, Texas, United States
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Kris Ivey
Colleague at Gould & Lamb, LlcFlower Mound, Texas, United States
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Sonja Thomas
Colleague at Gould & Lamb, LlcPlano, Texas, United States
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BH
Bridget Hertel
Colleague at Gould & Lamb, LlcBismarck, North Dakota, United States
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PM
Pamela Murphy
Colleague at Gould & Lamb, LlcGainesville, Georgia, United States
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DM
Deedee Maciel
Colleague at Gould & Lamb, LlcOrange, California, United States
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VP
Victoria Phillips
Colleague at Gould & Lamb, LlcAtlanta Metropolitan Area, United States
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CC
Christopher Conners
Colleague at Gould & Lamb, LlcBradenton, Florida, United States
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Quick answers generated from the profile data available on this page.
Denise Burns, Rn, Ccm works for Gould & Lamb, LLC.
Denise Burns, Rn, Ccm is listed as Medical Care Evaluator Writer at Gould and Lamb LLC at Gould & Lamb, LLC.
AeroLeads has found 1 work email signal at @examworks-cs.com for Denise Burns, Rn, Ccm at Gould & Lamb, LLC.
AeroLeads has found 5 phone signal(s) with area code 630, 800, 949 for Denise Burns, Rn, Ccm at Gould & Lamb, LLC.
Denise Burns, Rn, Ccm is based in Aurora, Illinois, United States while working with Gould & Lamb, LLC.
Denise Burns, Rn, Ccm has worked for Gould & Lamb, Llc, The Trizetto Group, United Resource Networks / United Healthcare, First Health Corporation, and Comprehensive Rehabilitative Associates.
Denise Burns, Rn, Ccm's colleagues at Gould & Lamb, LLC include Tom Power, Kerry Zelanka, Andrea Gratopp, Kris Ivey, and Sonja Thomas.
You can use AeroLeads to view verified contact signals for Denise Burns, Rn, Ccm at Gould & Lamb, LLC, including work email, phone, and LinkedIn data when available.
Denise Burns, Rn, Ccm holds .Net Developer Certificate from Depaul University.
Denise Burns, Rn, Ccm is listed with skills including Healthcare, Hipaa, Technical Writing, and Health Insurance.
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