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Judi Sparks is listed as Utilization review nurse at PHYSICAN'S UNITED PLAN, based in Clermont, Florida, United States. AeroLeads shows a work email signal at edandjudi.com and a matched LinkedIn profile for Judi Sparks.
Judi Sparks previously worked as Patient Care Nurse at Good Shepherd Hospice and Revenue Integrity Auditor at Osceola Regional Medical Center. Judi Sparks holds Master Of Health Administration/Master Of Science, Nursing from University Of Phoenix.
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Lots of different experience but have been pointing to utilization review and education over the past fifteen years. Computer literate and experienced telecommuter. Goals to teach/research nursing or research insurance industry concerns after the doctorate.Specialties: Utlization review nurse, chart review, educator
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Responsible for utilization review for local hospitals, chart reviews, interaction with hospital staff regarding hospitalization lengths of stay and nursing facility admissions.
Responsible for total patient care for case load of up to sixteen hospice patients including medications, wound care, counseling, and overall coordination of hospice services.
Responsible for medical bill auditing, negotiations with insurance providers for final bill payment, ensuring coding compliance, assistance with chargemaster maintenance.
Responsible for reviews of patient charts to ensure appropriateness and timeliness of care, in accordance with Interqual guidelines. Communication/negotiation with health insurance personnel to obtain authorization for inpatient admission and continued stay certifications. Interaction with attending physicians and social workers regarding discharge plans
Responsible for pre-certification of beneficiaries inpatient admissions and outpatient treatments within the framework of a managed care organization. Initial quality assurance of planned or already-delivered care. Extensive use of InterQual and M & R guidelines. Was first in facility to utilize a completely paperless authorization process using PC. Assisted in initiation of telecommute project.
Responsible for patient care delivery in an intensive care setting, including but not limited to ventilators, intra-aortic balloon pumping and hemodynamic monitoring. Obtained in-house chemotherapy certification during
Monitoring data from national remote research sites; verifying accuracy and adherence to medical treatment protocols, assisting the Clinical Trials Director and Scientific Director as needed; frequent communication with distant clinics for data troubleshooting as well as database problems and questions.
Reconciliation of hospital bills with patient charts follow by negotiation with insurance carrier agents to determine final amount due client hospital by carriers. Was hired as part of the start up program for new site.
Worked as a registered nurse in different hospitals in Tennessee, Oklahoma and Illinois. Started Intensive Care nursing in May of 1982 and continued to practice until accepting auditor position.
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Judi Sparks works for PHYSICAN'S UNITED PLAN.
Judi Sparks is listed as Utilization review nurse at PHYSICAN'S UNITED PLAN.
AeroLeads has found 1 work email signal at @edandjudi.com for Judi Sparks at PHYSICAN'S UNITED PLAN.
Judi Sparks is based in Clermont, Florida, United States while working with PHYSICAN'S UNITED PLAN.
Judi Sparks has worked for Physican'S United Plan, Good Shepherd Hospice, Osceola Regional Medical Center, Orlando Regional Medical Center, and Humana Military Healthcare.
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Judi Sparks holds Master Of Health Administration/Master Of Science, Nursing from University Of Phoenix.
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