Kendra Henderson
Zebulon,NC
Summary
Accomplished LPN Charge Nurse and Claims Specialist with a proven track record at United Healthcare, demonstrating exceptional leadership and critical thinking skills. Excelled in managing patient care and streamlining claims processes, enhancing efficiency by over 30%. Expert in teamwork and adaptability, significantly improving patient and client satisfaction.
Overview
25
25
years of professional experience
Work History
LPN Charge Nurse
Springmoor Stewart Health Center
10.2018 - Current
- Deliver direct quality care to patients by evaluating medical conditions and managing and assessing treatments.
- Update patient medical records with services provided, health conditions, and response to treatments using Epic, and Matrix
- Assess patients' temperature, pulse, and blood pressure and recorded in electronic medical records.
- Assemble and used equipment such as catheters, tracheotomy tubes, or oxygen suppliers to effectively manage patient care.
- Document vitals and medical histories in patient charts when assessing patients and communicated patient information to physicians and other nurses for care continuity.
- Promote patient independence by teaching self-care skills and explaining conditions and medications.
- Achieved successful unit leadership by providing quality nursing care to 12 to 17 patients per day in 150-bed unit.
- Analyze patient assessments and laboratory data to bring any issues to attention of physicians.
Claims Adjustment Specialist
United Healthcare
09.2011 - Current
- Review and complete adjustments for overpayments and underpayments of previously processed claims of dedicated and undedicated policies
- Adjust medical claims according to specified procedures and standards meeting all production and quality standards
- Prioritized work to meet deadlines
Claims Specialist Subject Matter Expert
United Healthcare
06.2004 - 09.2011
- Followed up with coworkers on unresolved issues and determination of benefits on claims
- Reviewed guidelines and benefit determinations and claims documents to verify required information and secure any missing data for claim payment
- Evaluated and processed complex claims in strict timeframes.
- Obtain medical records to submit for determination by MCR and take appropriate steps based on decision to request additional information, uphold, deny or overturn services
- Worked with claims adjusters to expedite processing of claims in alignment with procedures.
- Worked with other SMEs and business segments to improve policies and procedures, templates, documents, and communication processes to help improve quality and processing procedures.
Medical Claims Representative
United Healthcare
04.2001 - 06.2004
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Paid or denied medical claims based upon established claims processing criteria.
- Managed large volume of medical claims on daily basis.
Customer Service Associate
United Healthcare
12.1999 - 04.2001
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Actively listened to customers, handled concerns quickly and escalated major issues to other departments
- Handled billing and payment issues by following guidelines and resolving disputes.
- Investigated and resolved customer and provider inquiries and complaints quickly by being able to reprocess claims while on the call.
Education
High School Diploma -
Jordan Matthews High School
Siler City, NC05.1990
Associate of Applied Science - Nursing
Davidson-Davie Community College
Thomasville, NC05-2024
Diploma Licensed Practical Nursing
Durham Technical Community College
Durham, NC04-2018
Skills
- Leadership and Management skills
- Strong Communication skills
- Problem solving
- Adaptability
- Critical thinking
- Teamwork
- Research skills
- Flexibility
Timeline
LPN Charge Nurse
Springmoor Stewart Health Center
10.2018 - Current
Claims Adjustment Specialist
United Healthcare
09.2011 - Current
Claims Specialist Subject Matter Expert
United Healthcare
06.2004 - 09.2011
Medical Claims Representative
United Healthcare
04.2001 - 06.2004
Customer Service Associate
United Healthcare
12.1999 - 04.2001
High School Diploma -
Jordan Matthews High School
Associate of Applied Science - Nursing
Davidson-Davie Community College
Diploma Licensed Practical Nursing
Durham Technical Community College
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