Almita L. Segars
Denial Prevention Nurse Consultant at Revecore
Based in Snellville, United States
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Seniority
Staff
Department
Healthcare & Human Services
Location
Snellville
Industry
Hospitals and Health Care
Company size
684
Contact information
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a•••••••@revecore.com
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Background
About Almita L. Segars
A board-certified RN well over 30 years. My career expands from Labor and Delivery, Mother Baby, GYN, Med-Surg, Clinics, Travel Nursing and now Utilization Review Nursing. As a Utilization Review Nurse, I have become an expert in critical thinking and problem-solving; due to dynamic care planning and understanding of Medicaid and Medicare guidelines. Experience with Prior Authorization and DRG Pre-certification. Reviews for authorization of payment from GA, VA and TN Medicaid/Medicare/ third party insurance, billing and coding. I also bring expertise in reviewing pre-service and post-service requests for clinical services. Successful at managing cost containment by assessing medical necessity and appropriateness of treatments while conducting forensic review of medical records. Eager to leverage dynamic skillsets to a remote role.
Decision-makers
Other people at Revecore
- JEStaff
Jeff Engler
Claims Analyst Gur · Healthcare & Human Services
- EPManager
Eric Parthe
Data Science Analytics Manager · Information Technology
- TGManager
Tiffany Grajeda
Va Supervisor · Operations
- PBStaff
Pamela Buerger
Claims Analyst · Healthcare & Human Services
- MFManager
Michael Fields
Medical Reimbursements of America, Inc · Healthcare & Human Services
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