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Jennifer Saunders

@jennifersaunders

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Registered Nurse focused on appeals, prior authorizations, and patient advocacy through precise clinical documentation.

United States

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What I'm looking for

I’m seeking a remote Appeals and Grievance RN role using my clinical knowledge and analytical skills to support quality and compliance—reviewing documentation, applying medical-necessity criteria, and advocating for patients throughout denials and appeals.

I’m a detail-oriented Registered Nurse with strong experience in care coordination, prior authorizations, and patient advocacy. In my current role, I review and process prior authorizations and appeals for medications, collaborating with providers to ensure accurate clinical documentation supporting medical necessity.

I also communicate directly with insurance companies regarding approvals, denials, and required documentation, while providing patient education and follow up about treatment plans and insurance requirements. I strengthen continuity of care by documenting thoroughly and applying established protocols to guide decisions, including risk-based escalation when needed.

Previously, I performed comprehensive patient assessments and developed care plans, coordinating with interdisciplinary teams to support appropriate treatment and discharge planning. I’m now seeking a remote Appeals and Grievance RN role where my clinical knowledge and analytical skills can support quality and compliance in healthcare delivery.

Experience

Work history, roles, and key accomplishments

Current

Registered Nurse (Appeals)

Current

Virtua Pulmonology

Nov 2022 - Present (3 years 7 months)

Reviewed and processed prior authorizations and medication appeals, partnering with providers to substantiate medical necessity with accurate clinical documentation. Coordinated with insurers on approvals/denials, managed medication refills, and educated patients on treatment and insurance requirements.

Prior Authorizations Medical Necessity Criteria Patient Advocacy Patient Education Medication Management Interdisciplinary Collaboration

COVID Triage Nurse

Virtua

Jan 2022 - Nov 2022 (10 months)

Performed telephonic COVID triage using established protocols, providing evidence-based guidance and documenting interactions for continuity of care. Escalated cases based on clinical findings and risk factors.

Clinical Documentation Risk Assessment Care Coordination Patient Education

Registered Nurse

Inspira Health Network

Aug 2019 - Jan 2022 (2 years 5 months)

Conducted comprehensive patient assessments and developed care plans, coordinating with interdisciplinary teams for appropriate treatment and discharge planning. Maintained detailed clinical documentation and advocated for patients to ensure appropriate services and interventions.

Care Plan Development Interdisciplinary Collaboration Discharge Planning Clinical Documentation Patient Advocacy Care Coordination

Unit Secretary

Virtua Hospital

Jan 2015 - Aug 2019 (4 years 7 months)

Managed patient admissions, transfers, and discharges using EMR systems and supported care coordination through departmental communication. Maintained accurate patient records to support workflow efficiency.

EMR Patient Transfers Care Coordination Medical Records Management Workflows

Server

Phily Diner

Sep 2012 - Jan 2015 (2 years 4 months)

Provided high-quality customer service while multitasking and resolving day-to-day issues in a fast-paced environment. Trained new staff and maintained consistent service standards.

Customer Service Multitasking Problem Solving Communication Staff Training Teamwork Service quality