Mae Claire Arevalo

As an NCLEX Reviewer, I conduct NCLEX comprehensive lecture and administering evaluation exam with rationalization of questions.

Telemedecine Nurse: Performs by phone, medical history-taking, review of systems, and assessment of caller-patients for appropriate management, referral to emergency services or referral to an appropriate physician in the caller’s state. Calls in doctors’ prescriptions to pharmacies. Uploads patients’ information to electronic medical records. Transcribes medical summaries recorded by doctors in the voice mail. Receives telephone requests for members’ medical records.Retrieves and transmits members’ medical records to physicians and healthcare facilities. Provided medical information and advice to member-clients by phone. Trains new agents. less

Utilization Management Reviewer: Processes pre authorization request received via fax or web. Conducts initial medical review to determine medical necessity of elective outpatient comprehensive imaging requests. Perform review activities for procedures that require preauthorization and o Issue approvals for studies that meet specified guidelines o Forward studies that do not meet the specified guidelines to the Medical Director. Provides optimum customer service. Maintains productivity, quality and other service standards. Documents appropriate clinical information into the prior authorization system. Participates in on-going training programs to ensure quality performance and compliance with guidelines. Other duties assigned.