Michelle Reimer
Maysville
Summary
Dynamic healthcare professional with extensive experience at Elderwood At Lockport, excelling in claims management and patient care. Proven ability to interpret policies and enhance workflows, leveraging strong financial acumen and exceptional customer service skills. Adept at utilizing Epic software to streamline processes and improve patient outcomes.
Overview
20
20
years of professional experience
Work History
Clinical Claims Coordinator
Illumifin
Remote
01.2025 - Current
- Coordinated claims processing to ensure timely resolution and compliance with policy guidelines.
- Assisted in data entry and verification, maintaining accuracy in claims records.
- Supported claims management team by preparing documentation for complex cases.
- Communicated with clients and providers to gather necessary information for claim assessment.
Registered Nurse Supervisor
Elderwood At Lockport
Lockport, NY
01.2024 - 01.2025
- Supervised nursing staff to ensure high-quality patient care and adherence to protocols.
- Coordinated patient admissions, discharges, and transfers to optimize workflow efficiency.
- Implemented training programs for new nurses to enhance skills and knowledge retention.
- Conducted regular evaluations of staff performance, providing constructive feedback for improvement.
Acute Hemodialysis Registered Nurse
Catholic Health System
Buffalo, NY
10.2021 - 01.2025
- Administered acute hemodialysis treatments to patients, ensuring adherence to established protocols and safety standards.
- Collaborated with multidisciplinary teams to develop and implement individualized patient care plans.
- Monitored vital signs and laboratory results, adjusting treatment plans based on patient responses and clinical guidelines.
- Educated patients and families on dialysis procedures, self-care techniques, and dietary restrictions for improved health outcomes.
Prior Authorization Specialist
Meadow Family Medicine
North Tonawanda, NY
09.2014 - 10.2021
- Processed prior authorization requests promptly while adhering to insurance guidelines.
- Reviewed clinical records to assess medical necessity and service eligibility.
- Collaborated with healthcare providers to gather additional information for swift approvals.
- Built and nurtured relationships with insurance representatives to enhance authorization processes.
- Led efforts to improve workflows, resulting in faster authorization decisions.
- Worked with physicians to collect essential clinical data for prior authorization requests.
Registered Nurse, Medical-Surgical Unit
Kaledia Health
North Tonawanda, NY
06.2006 - 09.2014
- Administered medications and treatments following established care plans.
- Performed patient assessments and tracked vital signs for prompt intervention.
- Assisted interdisciplinary teams in creating thorough care strategies.
- Guided patients and families on managing diseases and post-discharge care.
Education
Associate of Science - Nursing
SUNY Niagara
Sanborn, NYSkills
- Microsoft office
- Policy interpretation
- Claims management
- Financial acumen
- Customer service
- Epic software proficiency
- Prior authorization process
- Medical terminology
- Medical appeals handling
- Insurance verification
Timeline
Clinical Claims Coordinator
Illumifin
01.2025 - Current
Registered Nurse Supervisor
Elderwood At Lockport
01.2024 - 01.2025
Acute Hemodialysis Registered Nurse
Catholic Health System
10.2021 - 01.2025
Prior Authorization Specialist
Meadow Family Medicine
09.2014 - 10.2021
Registered Nurse, Medical-Surgical Unit
Kaledia Health
06.2006 - 09.2014
Associate of Science - Nursing
SUNY Niagara