nedra owens

Consistently exceeded performance metrics for assigned high-volume caseload by proficiently conducting assessments to identify ongoing medical, psychological, and social issues necessitating interventions. Evaluated requests for services encompassing admissions, discharges, and ongoing stays to ensure compliance with MCG criteria, as well as state, federal, and associated regulatory standards.

Responsible for thorough clinical review and data analysis and input of functional scores, psychotropic medication, wounds, coding, and relevant documentation utilized within ARD time frame for accurate PDPM reimbursement in a timely manner. Generated over $700,000 in revenue for 12 months consecutively, totaling $8.6M annually, by directly impacting facility reimbursement.

Directly responsible for increasing reimbursement rates by 38% and creating a budget of $684 daily in Medicare revenue per patient. Led and oversaw the PASRR process, including uploading PL1 data and completing assessments, ensuring compliance with state evaluation deadlines.

Managed the accurate and timely completion of all Medicare and Medicaid MDS, ensuring clinical skilled need was met and presented with supporting documentation. Collaborated with physicians, nursing staff, members of IDT, and other state agencies to ensure patients' clinical needs were met and verified all residents' PASRR status.

Completed the Texas Medicaid Case Management Certification. This certification equipped me with specialized knowledge in managing Medicaid cases and ensuring compliance.

Achieved Resident Assessment Coordinator-Certified (RAC-CT) status through AANAC. This certification signifies advanced proficiency in resident assessment and care planning.

Obtained certification as an MDS Coordinator, specializing in Medicare Reimbursement. This certification enhanced expertise in managing and optimizing healthcare financial processes.

Grade: 3.96

Activities and societies: Awarded the Artfully Creative Award in 2009.

Completed a comprehensive vocational degree program in nursing. Achieved a GPA of 3.96, demonstrating strong academic performance and dedication to the field.