RN

Yvette Carvale, RN

**** ***** ***** ******

San Antonio, TX 78250

210-***-**** ********@*******.***

Education

•Medical Assistant Everest College, Springfield, MO

•Vocational Nursing Galen College of Nursing, San Antonio, TX

•ADN Bridge Galen College of Nursing, San Antonio, TX

September 2010

September 2020

October 2022

Professional Experience

CareCentrix

July 2024-October 2024

RN, PAC nurse, post acute admissions

Post Acute admissions for skilled nursing facilities.

InterQual reviews

Request for information/ phone call/ correspondence

Expedited reviews

Insurance verification

Intake 98/Q manager

Rightfax

Homebridge, authorization editing/canceling

Centene Corporation

June 2023-June 2024

RN, Central Concurrent Review

•Inpatient clinical review/MCG/InterQual

•Approval/discharge notification/DCP

•Census management/HRP identification

•HCA portal access

•RFI/P2P/Denials

•Inpatient administrative denials/approvals, auto approvals

•Hospice, mental health, pediatric/OB, concurrent, and retro authorizations

•TruCare EMR, PMD eligibility website

•ICD-10 coding

UnitedHealthcare/WellMed

January 2021-June 2023

LVN, Central Concurrent Review

•Inpatient clinical review/MCG/InterQual

•Approval/discharge notification

•Census management/HRP identification

•HCA Portal access

•RFI

•Inpatient administrative denials/approvals

•Hospice, mental health, concurrent retro authorizations

•TruCare EMR

UnitedHealthcare/WellMed

February 2020-January 2021

CTA, Medical Management Weekend Lead

•RFI

•Build inpatient authorizations, checking insurance eligibility

•RightFax medical records uploading clinicals to member records

•Management of weekend workflow/queues, report to management, delegate authorizations to team

•Approval/discharge notification

•HRP

Texas Pain Physicians

November 2018-October 2019

Certified Medical Assistant/OR Surgical Tech

•C2 medication refills

•Prior Authorizations

•RightFax document assignment

•Outpatient procedure set up

•Urine drug screen collection/processing

•Initiating IV access for conscious sedation

•Recovering patients from conscious sedation

•Sterile technique/field set up

•positioning of fluoroscope

•Stock operating room/Autoclave

• eClinicalWorks EMR

HealthTexas Medical Group

January 2018-November 2018

Certified Medical Assistant

•Phlebotomy & Laboratory Procedures

•Immunizations & Injections

•EKG / PFT / ABI

•Medication Refills & Prior Authorization

•Patient Appointment Scheduling, triage

•Wound care

•eClinicalWorks EMR

San Antonio Infectious Disease

August 2017- January 2018 Certified Medical Assistant

•Phlebotomy & Laboratory Procedures

•Immunizations & Injections

•Medication Refills & Prior Authorization

•Patient Appointment Scheduling, triaging

•eClinicalWorks EMR

Mercy Hospital Clinic & Mercy Hospital Urgent Care

November 2011- June 2017

Certified Medical Assistant/Laboratory Assistant I

•Phlebotomy & Laboratory Procedures

•Clinical & Diagnostic Procedures

•EKG / PFT / X-Ray

•Medication Refills/Prior Authorization

•Patient Appointment Scheduling

•CLIA / MLE Certification

•EPIC EMR

Exam One – Insurance Physicals and Employee Screening of Southwest Missouri March 2015-September 2015

Mobile Physical Examiner

•Paramedical Exams

•Wellness Lab Testing

•Phlebotomy & Laboratory Procedures

•EKG

•Biometrics

Certification/Licensure

•Phlebotomy Technician (American Society for Clinical Pathology)

•American Red Cross First Aid / Adult CPR / Child CPR

•IV certification

•RN license # 1015782

Knowledge of Utilization management, Concurrent review, inpatient reviews, managed care, insurance eligibility, ICD coding, Microsoft Word/Teams, Jabber, Excel, Power Point, RightFax, Report manager, HCA Portal access, MCG, InterQual, TruCare EMR, IKA, RSA soft token.

Up to date Covid vaccination

Contact this candidate