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@juliaduke
Dedicated nursing professional with over 20 years of experience.
United StatesI am a highly motivated and dedicated nursing professional with over twenty years of experience in various nursing roles. My journey in the nursing field has been marked by continuous learning and a commitment to providing exceptional patient care. I thrive in collaborative environments and enjoy working closely with my colleagues to ensure the best outcomes for our patients.
Currently, I serve as a Claims/Reconsiderations/Reimbursement Review Nurse at Providence Health Plan, where I conduct post-service reviews on denied claims and analyze hospital cases for preventable adverse events. My previous roles have included concurrent review nursing and telephonic triage, where I utilized my clinical expertise to support patients and healthcare teams effectively. I am passionate about improving healthcare processes and outcomes through diligent review and assessment.
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Work history, roles, and key accomplishments
Providence Health Plan
Apr 2024 - Present (1 year 7 months)
Provided post-service reviews on denied claims and conducted reviews on hospital deaths and Medicare claims for preventable adverse events. Utilized various reference resources including Interqual, Medical Policy, and MCG guidelines.
Providence Health Plan
Mar 2015 - Present (10 years 8 months)
Provided concurrent review nursing using Interqual criteria for inpatient Providence Health Plan members. Assisted inpatient case managers with discharge planning.
Providence Telephone Triage
Sep 2014 - Present (11 years 2 months)
Provided telephonic triage nursing advice to patients ranging from newborn to geriatric. Charting was done on computers using Epic and E Centaurus programs.
Eisenhower Medical Center
Sep 2012 - Present (13 years 2 months)
Provided nursing care to medical/oncology patients within the hospital setting. All charting was done on computers with medication scanning technology.
Scripps System-wide Resource Services
Sep 2011 - Present (14 years 2 months)
Provided nursing care to medical/surgical patients in a floating position across five main Scripps hospitals. Utilized computerized charting with medication scanning technology.
Sacred Heart Medical Center Riverbend
Apr 2009 - Present (16 years 7 months)
Provided nursing care to neurology patients within the hospital setting. All charting was done on computers with medication scanning technology.
Providence St Vincent Medical Center
Oct 2005 - Present (20 years 1 month)
Provided nursing care to general surgical and orthopedic patients within the hospital setting. All charting was done on computers with medication scanning technology.
Providence Center for Medically Fragile Children
Aug 2004 - Present (21 years 3 months)
Provided nursing care to developmentally and physically disabled pediatric patients in a long-term residential care facility. Charting was done both on paper and computer.
Hillsboro Rehab and Specialty Care
Jun 2003 - Present (22 years 5 months)
Provided nursing care to patients in skilled, long-term care, and memory care settings with an average patient load of 15-23. All charting was done on paper.
Degrees, certifications, and relevant coursework
Associate's Degree in Nursing, Nursing
Grade: 3.2
Obtained an Associate's Degree in Nursing, focusing on foundational nursing principles and patient care. Achieved a GPA of 3.2.
Bachelor's Degree in Nursing, Nursing
Grade: 3.82
Completed a Bachelor's Degree in Nursing through an online program, expanding knowledge in advanced nursing practices and healthcare systems. Maintained a strong academic record with a GPA of 3.82.
United StatesYou can contact Julia and 90k+ other talented remote workers on Himalayas.
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