Regina Smith
@reginasmith
Licensed practical nurse focused on care coordination, utilization review, and accurate chart documentation.
United StatesWhat I'm looking for
I’m a multi-state licensed Licensed Practical Nurse (LPN) with 14 years of experience providing quality clinical and skilled-care, including service-focused work across changing workflows and provider needs.
In my current Care Coordination Chart Review/ Data Support Specialist III Nurse role, I support utilization review and HEDIS processes by performing complete and accurate data entry of qualifying nursing services, abstracting charts, and auditing medical records for patterns of missing or incomplete documentation.
I’ve handled prior authorizations and appeal-related work by reviewing incoming referral documentation, submitting clinical documentation to insurance companies for authorization approval, and ensuring careful, detailed recordkeeping with strong attention to completeness and accuracy.
I bring advanced comfort navigating EMR systems (EPIC, Wellsky, Athena) and productivity tools (Microsoft Office, Google Suites), plus strong HIPAA-minded documentation practices. I also have hands-on experience across med/surg, telemetry, rehabilitation, hospice intake support, and correctional nursing.
Experience
Work history, roles, and key accomplishments
Data Support Specialist III
Intrepid Abstraction Utilization Review Healthcare
Jan 2022 - Present (4 years 7 months)
Performs HEDIS 101 data abstraction and utilization review chart review, entering and auditing nursing documentation for completeness and accuracy. Reviews referral documentation and submits clinical records to insurance companies for authorization of services.
Rehab Staff Nurse
Shore Nursing & Rehabilitation Center
Nov 2020 - Jan 2022 (1 year 2 months)
Provided rehab nursing care and created individualized care plans using clinical assessment and ongoing collaboration with the care team. Served as a liaison for ordered education and supported medication administration systems while maintaining confidentiality.
Clinic Nurse (Primary/Specialty)
Riverside Eastern Shore Physicians & Title
Feb 2013 - Aug 2020 (7 years 6 months)
Provided primary and specialty care nursing and performed chart reviews and documentation submission for authorization approvals with insurance companies. Abstracted charts to ensure Medicare and commercial paid patients were up to date on preventative care and managed referrals and electronic medical record updates.
Correctional Nurse
Corizon Healthcare
Oct 2008 - Oct 2018 (10 years)
Provided clinical support covering the Department of Corrections, using EMR systems to implement interventions and document clinical metrics based on physician instructions. Completed daily case reviews, documented patient responses/effectiveness/complications, and supported medication and triage activities.
Correctional Nurse
Correctional Medical Services
Oct 2008 - Oct 2018 (10 years)
Provided clinical support for the Department of Corrections, implementing medical plan interventions and documenting clinical data based on physician instructions. Completed daily case reviews, documented nursing encounters, and performed infirmary care including medication count and triage.
Correctional Nurse
Wexford Health Services
Oct 2008 - Oct 2018 (10 years)
Provided clinical support for the Department of Corrections, implementing medical plan interventions and documenting clinical records in EMR. Performed daily case reviews, documented nursing encounters and triaged medical and mental health complaints.
Admissions Support Facilitator
Coastal Hospice
Sep 2010 - Jul 2011 (10 months)
Processed hospice intake referrals by reviewing clinical documentation and contacting providers and insurance companies to support submission. Managed admission forms and follow-ups to ensure continuity of care.
Med/Surg Nurse (Telemetry)
Shore Memorial Hospital
Jun 2008 - Apr 2009 (10 months)
Provided telemetry/med-surg nursing care using EMR systems, including assessment, planning, implementation, and evaluation of patient needs. Collaborated with physicians and the medical team to support continuity of care and promote recovery for patients and families.
Education
Degrees, certifications, and relevant coursework
HEDIS 101 Data Abstraction
Certificate of Completion
Earned a certificate of completion for HEDIS 101 Data Abstraction in August 2022.
Utilization Review-101
Certificate of Completion
Earned a certificate of completion for Utilization Review-101 in July 2022.
Riverside Rehabilitation Center
2011 - 2013
Completed an educational/training period at Riverside Rehabilitation Center from July 2011 to February 2013.
Eastern Shore Community College
Licensed Practical Nurse (LPN), Licensed Practical Nursing
Completed Licensed Practical Nursing training (LPN) in May 2008.
Remote Learning Services, LLC
Completed remote learning instruction in May 2008.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
Skills
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