Amanda Usher

• Assess patient symptoms, medical history, and immediate needs via phone to determine the urgency and appropriate level of care.
• Provide comprehensive telephone-based triage and medical advice to patients across a wide range of medical conditions.
• Offer evidence-based guidance and educate patients on managing health conditions at home, including red-flag symptoms that require escalation.
• Coordinated care with physicians, nurses, and other healthcare providers to ensure continuity of care and timely follow-up.
• Tracked patient outcomes and performed follow-up calls to assess symptoms and reinforce care plans.
• Documented patient interactions accurately in electronic health records, ensuring compliance with clinical and legal standards.
• Maintain professionalism, empathy, and composure while handling high-volume and high-acuity calls.

LPN applying clinical judgment and ICD‑10‑CM coding expertise to support Medicare Advantage risk adjustment (HCC) accuracy in compliance with CMS guidelines.

• Conducted prospective and retrospective chart reviews to identify undocumented and suspect HCCs, enhancing accuracy of risk adjustment.
• Collaborated with providers and cross-functional teams to enhance HCC capture, mitigate compliance risk, and advance value-based care initiatives.
• Leveraged nursing knowledge of pathophysiology, anatomy, and disease progression to validate diagnoses and ensure clinical documentation integrity.
• Analyzed provider documentation and developed queries to improve coding specificity, ensuring comprehensive clinical documentation.
• Achieved 98%+ coding accuracy while maintaining productivity of 30/1,200 charts per day/week within established quality benchmarks.

• Administered vaccines and provided telephonic triage, adhering to CMS, CDC, and infection control protocols.
• Conducted patient health assessments to evaluate vaccine eligibility and symptom severity.
• Performed telephone triage for employees, scheduling COVID tests and delivering guidance based on clinical criteria.
• Monitored patients for post-vaccination adverse reactions and escalated concerns following established protocols.
• Educated patients and employees about COVID-19 processes, vaccination benefits, side effects, and return-to-work criteria.
• Documented encounters, vaccine administration, and triage outcomes in electronic health records, ensuring HIPAA compliance.
• Maintained compliance with documentation standards and clinical protocols to support audit readiness.
• Managed patient flow in clinic and call center operations, prioritizing care needs and assisting leadership.

• Prepped exam rooms, sterilized equipment, assisted in procedures/diagnostic test, administered vaccination and immunizations, and conducted pre-exam assessments such as vitals, medical histories etc.
• Educated patients on procedures/testing, their health conditions, medication usage, and self-care techniques to promote proactive healthcare management.
• Implemented targeted interventions to enhance departmental performance metrics.

• Supported adult and pediatric ENT specialty practices across multiple clinic locations, enhancing continuity of care for diverse patient populations.
• Functioned as a liaison for patients, families, and providers to promote clear communication about diagnoses, treatments, and care plans.
• Managed outpatient procedure scheduling to increase patient access.
• Streamlined referral and authorization processes to facilitate timely access to specialty evaluations and treatments for patients.
• Verified insurance coverage and secured prior authorizations, including expedited requests for urgent services, ensuring prompt patient care.
• Provided patient education on disease management, medication administration, and self‑care, reinforcing provider treatment plans.
• Reviewed patient charts and medical histories to support accurate understanding of diagnoses, treatments, and ongoing care needs.
• Utilized electronic health record (EHR) systems for accurate data entry, chart review, and clinical documentation.
• Applied working knowledge of AMA and CMS coding conventions to assign and support accurate diagnostic coding.
• Monitored updates to coding and regulatory guidelines, supporting compliance and documentation accuracy.

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• Managed complex and high‑risk cases involving multiple medical conditions through thorough assessment, monitoring, and timely intervention.
• Coordinated healthcare services across multidisciplinary teams to improve continuity of care for diverse patient populations.
• Delivered emotional and practical assistance to individuals facing complex health challenges, promoting patient comfort, safety, and adherence to care plans.
• Built strong, trusting relationships with patients and families by maintaining clear communication and providing consistent, compassionate support.
• Completed detailed clinical tasks including medication setup, vital signs monitoring, skin integrity assessments, diabetic nail care, and behavior observation for individuals with disabilities.
• Maintained a high level of accuracy and attention to detail when documenting patient status, changes in condition, and care provided.

• Streamlined medication administration processes for improved accuracy, reducing medication errors and ensuring patient safety.
• Managed complex wound care cases, applying advanced knowledge of wound healing principles to achieve optimal results.
• Improved infection control measures by closely monitoring staff adherence to proper hand hygiene protocols.
• Assembled and used equipment such as catheters, tracheotomy tubes, or oxygen suppliers to effectively manage patient care.
• Developed strong relationships with patients' families, keeping them informed of progress reports and collaborating on decisions regarding their loved ones' healthcare plans.
• Communicated patient information to physicians and nurses for care continuity.
• Analyzed patient assessments and laboratory data to bring any issues to the attention of physicians.
• Provided compassionate end-of-life care, supporting patients and their families through difficult times.
• Responded to patient request and helped long-term care residents with bathing, dressing, feeding, and other daily living activities.

• Monitored patient status, treatment‑plan adherence, and response to therapies to manage chronic conditions and report changes to providers.
• Maintained detailed, accurate medical records to support continuity of care, follow‑up treatments, and clinical decision‑making.
• Administered medications per provider orders to treat conditions and alleviate symptoms, monitoring for therapeutic response and adverse effects.
• Completed focused physical assessments and collected patient medical data to facilitate efficient, high‑quality office visits.
• Provided hands‑on support to physicians during basic and invasive procedures, ensuring patient safety and procedural efficiency.
• Assisted with ordering and tracking diagnostic tests and communicated results to support timely diagnosis and care planning.
• Reviewed outpatient records and provider documentation to identify diagnoses and procedures accurately.
• Coordinated with insurance companies to obtain prior authorizations for procedures, medications, diagnostic testing, labs, DME, and referrals.
• Educated patients on insurance benefits, coverage limitations, and authorization requirements, improving understanding and reducing care delays
• Supported team knowledge‑sharing initiatives through training sessions, documentation reviews, and workflow discussions.