Summary
Overview
Work History
Education
Skills
Accomplishments
Certification
Timeline
Generic

Sydney Marshall

Booneville

Summary

Professional nurse consultant prepared for this role. Proven track record in healthcare consulting with strong focus on patient care and clinical operations. Adept in team collaboration and delivering results under changing circumstances. Skilled in clinical assessments, regulatory compliance, and process improvement. Known for reliability, flexibility, and achieving impactful outcomes.

Overview

9
9
years of professional experience
1
1
Certification

Work History

UM Nurse Consultant / Team Lead

Aetna/ CVS
10.2022 - Current
  • Performs audits and evaluations of patients denial and approval letters within the health plan
  • Works collaboratively with doctors to discuss approvals and denials of procedures, services, and medical equipment
  • Utilizing coding for specific state health plan standards such as DRG or MCG credentials
  • Utilizing the center for Medicare and Medicaid with the primary physician to ensure that our insurance facility is paying adequately
  • Ensuring that the primary physician is appropriately charting the primary diagnosis and secondary diagnosis to ensure that the right DRG amount is being set per inpatient visits


RN Leave Coordinator

Toyota (Premise HealthCare)
07.2022 - 10.2022
  • Performs duties such as providing patients health care assessments, answering questions about medical conditions or treatments, and providing them with referral if the patient requires further medical attention
  • As a leave coordinator, I would ensure that when charting on each patient that the codes were adequately charted
  • I would achieve this task by utilizing the most appropriate ICD-10 code, CPT code for on site procedure, and DRG regulations for our members with Medicare
  • I would also work with our on site facility along with the on site providers to conduct chart reviews to ensure that the appropriate codes were being utilized during their on site assessments
  • If inadequate codes were utilized we would develop a plan to to change the used code compared with national regulations (Medicaid and Medicare standards)
  • As a telecommunication RN I also utilize case management duties and follow the patients’ cases to ensure that they receive the proper care

Emergency and Trauma Staff Nurse

Kentucky River Medical Center
12.2021 - 07.2022
  • Administered medications and treatments according to established protocols and patient care plans.
  • Collaborated with interdisciplinary teams to develop and implement individualized patient care strategies.
  • Monitored vital signs and documented changes, ensuring timely interventions for optimal patient outcomes.
  • Educated patients and families on health management and post-discharge care to enhance recovery processes.

Clinical Nurse Manager

Family Practice Clinics
05.2020 - 12.2021
  • Led team in delivering high-quality patient care, enhancing clinic efficiency.
  • Developed and implemented protocols to improve patient outcomes and safety.
  • Mentored nursing staff, fostering professional growth and skill development.
  • Coordinated interdisciplinary team meetings to optimize treatment plans.

Referral Clerk

Family Practice Clinics
06.2018 - 05.2020
  • Processed and managed patient referrals to ensure timely access to healthcare services.
  • Coordinated communication between healthcare providers and patients to streamline referral processes.
  • Maintained comprehensive records of patient referrals using electronic health record systems.
  • Reviewed and verified referral documentation for accuracy and compliance with policies.

Urine Specimen Collector

Genetox Laboratories
01.2016 - 05.2018
  • Collected and processed biological specimens following established protocols and guidelines.
  • Ensured specimen integrity by adhering to chain-of-custody procedures during collection.
  • Maintained accurate records of specimen collection, tracking, and storage for compliance purposes.
  • Collaborated with laboratory personnel to streamline specimen processing workflows, enhancing efficiency.

Education

Master of Science - Nursing Family Nurse Practitioner

Northern Kentucky University
11.2024

Bachelor of Science - Nursing

Northern Kentucky University
06.2021

Associate of Science - Nursing

Galen College of Nursing
04.2020

High School Diploma -

Owsley County High School
Booneville, KY
01.2014

Skills

  • Medicare and Medicaid coding (CPT and ICD-10)
  • MCG standards
  • DRG Standards and Regulations
  • Interprofessional collaboration
  • Healthcare management
  • Quality improvement
  • Staff training
  • Patient relations
  • Data analysis
  • Records review
  • Report writing

Accomplishments

  • Quality Assurance- Ensured and enforced medical office compliance with HIPAA, OSHA and CLIA regulations for maximum quality and control.
  • Patient Advocacy- Explained treatment procedures, medication risks, special diets and physician instructions to patients.
  • Selected for two scholarships while enrolled at Owsley County High School: The William Eversole Scholarship and the Rogers Scholar scholarship.
  • Certified in BLS, ACLS, POLS, and NNC.

Certification

  • Licensed Family Nurse Practitioner (ANCC certified)
  • Licensed Registered Nurse (BSN)

Timeline

UM Nurse Consultant / Team Lead

Aetna/ CVS
10.2022 - Current

RN Leave Coordinator

Toyota (Premise HealthCare)
07.2022 - 10.2022

Emergency and Trauma Staff Nurse

Kentucky River Medical Center
12.2021 - 07.2022

Clinical Nurse Manager

Family Practice Clinics
05.2020 - 12.2021

Referral Clerk

Family Practice Clinics
06.2018 - 05.2020

Urine Specimen Collector

Genetox Laboratories
01.2016 - 05.2018

Bachelor of Science - Nursing

Northern Kentucky University

Associate of Science - Nursing

Galen College of Nursing

Master of Science - Nursing Family Nurse Practitioner

Northern Kentucky University

High School Diploma -

Owsley County High School

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Sydney Marshall