Kristen McAtee
Tempe
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Devoted to giving every customer a positive and memorable experience.
Overview
8
8
years of professional experience
Work History
Utilization Review Specialist
Medusind
Tempe
06.2024 - 09.2025
- Reviewed patient records to determine medical necessity for services.
- Assisted in evaluating treatment plans for compliance with guidelines.
- Maintained updated knowledge of insurance policies and reimbursement criteria.
- Reviewed appeals from providers regarding denied admissions or services according to organizational standards and procedures.
- Served as a liaison between payers, providers, patients and families concerning authorization decisions.
- Conducted concurrent reviews to monitor the ongoing appropriateness of services provided to members.
- Coordinated with healthcare teams to develop care plans that meet patient needs and insurance coverage.
Clinical Coordinator/Utilization Review Coordinator
Pinnacle Peak Recovery
Scottsdale
08.2017 - 04.2024
- Monitored compliance with healthcare regulations and standards.
- Supported clinical staff in implementing new protocols and procedures.
- Facilitated communication between patients, families, and healthcare providers.
- Organized training sessions for new clinical staff on operational processes.
- Managed patient flow and directed nurses and doctors to ensure medical assignments are completed on time.
- Organized continuing education opportunities for staff members related to their respective roles.
- Coordinated weekly work schedules for department employees.
- Ensured compliance with all applicable laws, regulations, policies, and procedures governing healthcare service delivery.
Education
High School Diploma -
Denfeld Senior High School
Duluth06-2002
Skills
- Medical necessity review
- Treatment plan evaluation
- Insurance compliance
- Appeals processing
- Utilization management
- Healthcare regulations
Timeline
Utilization Review Specialist
Medusind
06.2024 - 09.2025
Clinical Coordinator/Utilization Review Coordinator
Pinnacle Peak Recovery
08.2017 - 04.2024
High School Diploma -
Denfeld Senior High School
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