Open to opportunities

Rebecca Mcmullen

@rebeccamcmullen

Message

I streamline clinical reviews, prior authorizations, telehealth, and compliant patient care operations.

Zimbabwe

Message

What I'm looking for

I'm seeking a remote healthcare role where I can apply my clinical review, prior authorization, telehealth, documentation, and virtual team coordination experience to support compliant, efficient patient care.

I've supported clinical review and prior authorization operations at Bayhealth, Acentra Health, and Interim HealthCare, processing requests, Medicare appeals, utilization reviews, and patient assessments.

In remote nursing roles, I've conducted telehealth consultations, coordinated high-volume inbound and outbound calls, worked with field nurses and providers, and tracked case and call data in Excel. I use CPT, ICD-10, HCPCS, MCG, electronic health records, and CMS guidelines to support accurate, timely care decisions.

I've also delivered direct patient care in emergency, clinic, rehabilitation, and immunization settings while leading MDS coordination, medical-record audits, compliance training, and care-plan collaboration.

Experience

Work history, roles, and key accomplishments

Current

LPN Triage/Prior Auth Nurse

Current

Bayhealth

Oct 2025 - Present (11 months)

Reviews and processes prior authorization requests for medical procedures and medications, applying knowledge of medical terminology and coding systems. Provides telephone triage services, assesses patient symptoms, and documents interactions in electronic health records.

CPT ICD 10 HCPCS Prior Authorizations Telephone Triage Electronic Health Records Medical Terminology