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Diane Welzel

739 Rattling Run Road, Mickleton, NJ 08056


(856) 467-4025
(570) 578-5700 (Cell)
dw52e68c@westpost.net
Licensed in PA and NJ
PROFILE
Strong background in Employee Health and Customer Service.
Hard-working team player with great communication skills and an excellent attend
ance record.
Computer skills include: Microsoft Windows, Microsoft Word, and Microsoft Excel.
EXPERIENCE

Albert Einstein Healthcare Network


Oct. 2009 to Present
LPN/Payer Specialist - PRN Discharge Planning Coordinator
* Extrapolates clinical information from the clinical record to prepare a review
for payers during the certification process.
* Collaborates with Care Managers to provide specific clinical information to 3r
d party payers.
* Responsible for timely provision/flow of clinical information to/from 3rd part
y payers and Care Managers to ensure certification/approval of inpatient and pos
t discharge service.
* Ensures that referrals are made to appropriate community resources in a timely
manner.
* Supports the Resource Center Staff as needed with difficult cases and acts as
a resource for medical terminology.
Concentra Health Services Aug. 2007 - Mar. 2009
Employee Health Nurse
* Responsible for testing or monitoring symptoms of 7,000+ employees of contract
ed hospital.
* Place annual or semi-annual PPD injections to test for Tuberculosis and perfor
m follow-up reading.
* Schedule annual testing for individual departments in each location citywide.
* Provide annual Flu vaccinations for employees.
* Order required supplies for above testing and vaccinations.
* Provide testing details to Department Supervisors while complying with HIPAA r
egulations.
Alliance Healthcare Information April - Aug. 2007
Pharmacovigilance Nurse
* Received incoming phone calls from patients, responsible parties and healthcar
e providers.
* Determined whether the provided information warrants an Adverse Event (AE) for
m, a Product Quality Complaint (PQC) form or a Positive Feedback form for submis
sion to the contracted Pharmaceutical Corporation.
* Performed "call-backs" to individuals leaving messages regarding contracted me
dications.
* Coordinated returns or replacement due to product manufacturing malfunctions.
* Submitted pharmacy refunds or replacement due to customer returns.
Greater Lehigh Valley Visiting Nurse Association
Customer Support Nurse/Intake Coordinator
* Coordinate scheduling activities for all clinical staff and direct staff with
assignments. Manage authorization process and communicate with various payers to
achieve ongoing clinical coverage.
* Perform intake process by accepting new clients, allocating ICD-9 and CPT-4 co
des, completing data entry and assigning staff members to respective clients.
* Assist director with various functions including managing staff productivity,
quality of care and coordination of services 2001 - 2007
Atria Assisted Living Facility 1999 - 2001
LPN/Second Shift Supervisor
* Oversaw medical staff and assigned PCAs daily responsibilities.
* Filled and corrected weekly Medisets for resident medications. Updated charts
and med records. Maintained narcotic and syringe counts.
* Administered meds to residents as required (PO, IM, SQ, PRN). Performed chart
audits, completed admissions, contacted facilities and physician's offices to ob
tain and maintain records in compliance with state regs.
* Provided tours of facility to those looking for placement of a family member.
Blue Cross of NEPA
Inquiry Services Representative
* Advised members and providers of coverage benefits.
* Educated members and providers about referrals and pre-certifications.
* Investigated and explained reasons for denials. Forwarded denied claims for re
processing.
* Followed up with Utilization Management on Pre-certifications. 1998 - 1999
Bradley Caldwell, Inc.
Customer Service Agent
* Entered dealer orders into computer system.
* Issued credit and resolved deliver problems.
* Researched special orders and general troubleshooting. 1996-1998
C.A.R.E. Resources, Inc.
Medical Analyst/Corporate Trainer
* Analyzed medical records and hospital billing to insure proper billing practic
es.
* Recorded payments from insurance companies.
* Interviewed and trained new employees in company policies and procedures.
* Surveyed prospective hospital clients to inform them of revenue potential.
Presented performance updates to CFOs of hospitals in Florida, South Carolina (2
), Mississippi (3), Illinois, Pennsylvania (2), Virginia (2) and North Carolina.
* Designed customized surgical worksheets that facilitated and expedited analysi
s of surgical charts while reducing errors.
1993 - 1996
Young's Medical Equip.
Customer Service Rep/Patient Educator
* Received approx 65 phone calls daily along with walk-in referrals from institu
tions, physicians and private customers.
* Determined patient needs and customized equipment accordingly. Coordinated del
ivery or customer pick-up and researched special orders.
* Verified 3rd party insurance coverage (MC, BC/BS, DPA, WC & private insurances
). Prepared and sent MC non-assigned claims (300/mo).
* Educated patients on use of Home Blood Glucose monitors. 1992 - 1993
Hess's Department Stores
Corporate Health Nurse
* Answered emergency calls for sick or injured co-workers and customers.
* Coordinated blood drives, wrote health related articles for company news magaz
ine.
* Participated in a variety of human resource functions in regard to hiring and
promotion decisions. 1990 - 1991
Physician's Weight Loss Centers
Licensed Practical Nurse
* Performed phlebotomies, EKGs, diet counseling, patient evaluations and assessm
ents. 1989 - 1990
Ashland State General Hospital
Licensed Practical Nurse
* A member of the pediatric nursing staff and float pool.
* Assisted in the emergency department, intensive care unit, geriatrics, as well
as various medical/surgical areas as needed.
* Responsibilities spanned direct patient care, patient teaching, PO meds and ch
arting 1986 - 1989
Private Urological Office
Licensed Practical Nurse
* Assisted with minor surgical procedures (vasectomies, cystoscopies, etc.). Lab
oratory experience included running urinalyses, preparing and reading cultures a
nd sensitivities.
* Scheduled patients, performed back-office duties and recorded payments from pa
tients and insurance companies.
1983 - 1986
The Vision Academy/A Paul Mitchell Partner School 2006
Graduated in aesthetics.
Hazleton Area Vocational-Technical School 1982 - 1983
Practical Nursing Course
West Hazleton Jr-Sr High School 1981
Graduated in Academic course of study.

REFERENCES AVAILABLE UPON REQUEST