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@kprice

I’m a Texas-licensed LVN with 22+ years in case management, regulatory compliance, and zero-error clinical documentation.

United States
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What I'm looking for

I’m looking for a role where I can support VR and clinical case management with zero-error documentation, HIPAA-compliant regulatory accuracy, and cross-agency coordination—helping clients achieve sustainable employment outcomes.

I’m a Texas-licensed LVN with 22+ years of progressive healthcare case management, regulatory compliance, and clinical documentation expertise. I’m known for translating complex clinical data into compliant, actionable case files while maintaining ZERO-ERROR documentation standards across high-volume caseloads. I’ve also built deep strength in vocational rehabilitation support functions like intake screening, policy interpretation, and inter-agency coordination.

In my current role as a Clinical SME / Lead LVN, I provide comprehensive case management support for Med-Surg and Home Health populations, maintaining detailed electronic case files with 100% regulatory compliance and zero-deficiency audit results. I lead intake screenings and needs assessments to determine eligibility and appropriate resource allocation, and I manage high-stakes logistics tied to trust/PFO administration. I serve as a primary liaison between clinical teams, insurance payers, and service providers—resolving case-level discrepancies to keep service delivery uninterrupted.

I also bring payment integrity leadership from my work as a Clinical Review Specialist / Payment Integrity Lead, where I prevent improper payments through meticulous forensic claim investigations. Through defensible audit ecosystems, I’ve achieved a 99.8% documentation accuracy rate and prevented over $200,000 in improper payments, while collaborating cross-functionally to turn case data into process improvements. Throughout my career—including roles in prior authorization, nursing QA, and payer liaison compliance—I’ve aligned with the Texas Workforce Commission’s mission to help people with disabilities achieve employment prosperity through coordinated, person-centered services.

Experience

Work history, roles, and key accomplishments

HI
Current

Payment Integrity Lead LVN

Healthcare Audit Solutions Inc.

Oct 2024 - Present (1 year 7 months)

Led forensic claim investigations and case file audits to prevent over $200,000 in improper payments through meticulous review. Built defensible audit ecosystems achieving 99.8% documentation accuracy and streamlined compliance reporting with reliable audit trails.

BI
Current

Lead LVN Case Management

Beauty Bey Ministries, Inc.

Jan 2023 - Present (3 years 4 months)

Provided comprehensive Med-Surg and Home Health case management, maintaining detailed electronic case files with 100% regulatory compliance and zero-deficiency audit results. Conducted intake screenings and needs assessments and served as a primary liaison to resolve case-level discrepancies.

Kelsey Seybold logoKS

Prior Authorization Nurse

May 2022 - Sep 2024 (2 years 4 months)

Managed a high-volume specialty caseload, completing individual needs assessments and clinical screenings processing 50+ cases daily with zero backlog. Prevented downstream payment disputes by interpreting complex payer policies and eliminating $120,000 in annual billing errors through pre-payment review safeguards.

WR

Med-Surg LVN QA Coordinator

Winthrop Manor LTC & Rehabilitation

Jan 2022 - Jan 2023 (1 year)

Directed nursing workflows and ensured zero-error medication administration records through rigorous case documentation and quality assurance for high-acuity rehabilitation residents. Completed routine case file reviews and prepared regulatory survey technical reports with 100% on-time submission.

MG

Compliance & Payer Liaison Supervisor

Merdia Healthcare Group

May 2016 - May 2022 (6 years)

Orchestrated end-to-end payment integrity audits and case file reviews, recovering $85,000 in erroneous payments while strengthening compliance controls. Built and scaled a 5 FTE analyst team, reducing onboarding time by 40% through standardized training and managing MOUs/LOAs to ensure payer documentation met regulatory requirements.

Education

Degrees, certifications, and relevant coursework

TC

TEXAS CAREERS

Licensed Vocational Nurse (LVN) Diploma, Nursing

2003 - 2004

Completed a Licensed Vocational Nurse (LVN) Diploma Program in San Antonio, Texas.

Tech stack

Software and tools used professionally

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