Crystal Martin, Lpn

Licensed Practical Nurse with 10+ years of progressive clinical experience specializing in utilization management support, medical record review, prior authorizations, admissions, and care coordination. Experienced in reviewing clinical documentation to support medical necessity, verifying insurance eligibility, coordinating multidisciplinary care, and ensuring compliance with Medicare, Medicaid, and commercial payer guidelines. Proven ability to manage 15–20 referrals and authorization requests daily while maintaining accuracy, regulatory compliance, and exceptional patient advocacy.

Proficient in Epic, Homecare Homebase (HCHB), WellSky/Kinnser, PointClickCare, Microsoft Teams, and Adobe Acrobat. Seeking a remote Utilization Management, Utilization Review, Clinical Review, or Case Management position.

Intake, Admissions & Authorization LPN - Home Healthcare 2000

(2019-03)

• Review physician orders, referrals, and medical records to evaluate documentation completeness and support medical necessity for home health services.
• Review clinical documentation for compliance with Medicare, Medicaid, and commercial payer requirements before initiating care.
• Process and coordinate approximately 15–20 patient referrals and prior authorization requests daily.
• Verify insurance eligibility, benefits, and authorization requirements.
• Collaborate with physicians, referral coordinators, case managers, and interdisciplinary teams.
• Monitor referral pipelines and resolve authorization barriers.
• Maintain accurate documentation within Epic, Homecare Homebase (HCHB), WellSky/Kinnser, and PointClickCare.
• Ensure compliance with HIPAA and payer guidelines.

Private Duty LPN - First Option Home Health

(2014-06 - 2019-03)

• Delivered skilled nursing care.
• Coordinated care with providers.
• Documented assessments in EHR.
• Educated patients and caregivers.
• Supervised home health aides.

LPN - Bayou Chateau Nursing Center

(2012-06 - 2014-06)

• Provided nursing care.
• Administered medications.
• Collaborated with interdisciplinary teams.
• Maintained compliant documentation.

Practical Nursing - South Louisiana Community College (T.H. Harris Campus)