Willie Collins Email & Phone Number

Reviewed bills and paid personal injury protection (PIP) bills received by the precertification nurses including: chiropractic physical therapy, orthopedic surgeons, physical medicine and rehabilitation, spinal surgeons, and more.Ensured quality of reports by physicians, reviewing Independent Medical Exam (IME) reports for details such as physical exams, patient history, pre-existing conditions, diagnoses, treatment recommendations, prognosis and disability if applicable.Reviewed all pre-hospital admissions

Developed and ensured accurate and appropriate documentation of patient plans and interactions.Provided bedside care including administered medications and documented therapeutic effects, took vital signs, administered injections and supported patients on ventilators.Maintained and ensured all regulations set forth by Medicaid, Medicare, private insurances, Centers for Medicare and Medicare Services (CMS), and state governing agencies were followed and that documentation demonstrated compliance.

Perform accurate and comprehensive review of medical recordsAudit high volume of medical records ensuring accuracy and appropriate code assignmentEnsuring accurate data entryEnsuring policies and procedures are monitored and updated to include regulatory changesEnsuring that the review of the medical records are in compliance with HEDIS specifications.

Ensured quality of reports by physicians, reviewing Independent Medical Exam (IME) reports for details such as physical exams, patient history, pre-existing conditions, diagnoses, treatment recommendations, prognosis and disability if applicable.Review attending physician’s treatment plan and certify treatment utilizing the Care Paths.Review and analyze the medical necessity of proposed treatment and testing in accordance with Decision Point Review PlanPrepared legal medical documents for peer review

Developed and ensured accurate and appropriate documentation of patient plans and interactions.The pre-certification nurse coordinator is responsible for the processing and verification for medical necessity of all outpatient pre-certification requests. Also responsible for the processing and verification of medical necessity, as well as the quality and cost effective and medically appropriate service's based on sound principles of practice

Duties and ResponsibilitiesPerform onsite office visits to obtain assigned medical records for review.Responsible for all assigned offices and abstractions.Interface with practitioner offices.Completeness/correctness of data collected/abstracted.Follow-up when needed.

Trained in patient care for fragile infants and children( G-T feeding, vent care and trach care).Adheres to the established physician's plan of treatment.Performs assigned duties appropriately and according to the nursing care plan.Demonstrates sound clinical judgement.Prepare and submits clinical notes weekly.Maintains professional demeanor at all times with family members and clients.

Performed cost-effective hospital and office audits, including thorough review, analysis and documentation of findings in medical and financial records.Effectively collaborated across employee levels to promote company goals and objectives.Applied excellent aptitude for analytical thinking and ability to quickly master new technology.Shared leadership and facilitation of training efforts for new personnel.Recognized for playing key role in X-ray quality assurance project.Revised and updated policies and procedures to improve efficiency.Skilled in CPT coding and ICD-9 billing