Jeanne Dixon Hynson, R.N.

, PAHM
15000 Laura Way, Alexander, AR 72002
Home Phone 501-794-1204, Cell Phone 501-909-9527
Areas of Expertise and Interest
* Medical Claims review, Utilization review, Case Management at
insurance Companies.
* Able to set the guidelines for claim payment policies.
* Have set criteria boundaries for several computer programs.
* A proficient knowledge source for CPT, HCPCS, and ICD-9 code
standards, also, knowledgeable in Hayes, Deloite and Touche, and
Milliman and Robertson criteria.
* Chosen as Charge Nurse for the newly developed Pediatric
Outpatient Surgery Center at Children's Hospital in 1981. Worked
with the Chief of Anesthesiology to set standards for patient
safety, comfort and follow-up for first pediatric One Day Surgery.
* Able to setup Employee Health Screening and Education Program.
* Hospice, Industrial Nursing, Neonatal and Pediatric patient care.
* Nursing Home Director, Residential care facility regulation
knowledge.
Registered Nurse Experience
Arkansas Blue Cross/Blue Shield - May 2009 to Feb.2010
RN Case Manager Patient advocate to maximize insurance benefits and
help guide the Walmart employees through the health care system.
Performed telephonic case management and disease management as a
health education resource for the patient or family. Performed
Concurrent Review, Discharge Planning and Case Management for
inpatients.
NovaSys Health Insurance - Jan. 2008 to Feb. 2009
Clinical Liaison- Health insurance claim review for medical necessity,
contract eligibility and Case Management.
QualChoice Health Insurance - Jan. 1999 to Dec. 2007
Clinical Claims Review- responsible for analysis and decisions on all
Medical Claims appeals.
Prepare decision letters after review of pre-service and post-service
requests
for medical necessity authorization.
Crossroads Hospice- Mar.1997 to Sept. 1998
Provided comfort care for an emotionally supported and pain-controlled
death.
Ar. Healthcare Personnel- June 1994 to Mar 1997
Temporary nurse staffing- Weekend Director of Nursing at Little Rock
Nursing Homes
and neonatal nursery staffing
USAble Medical Division- Feb. 1992 to May 1994
Utilization review of inpatient for medical necessity; claims pricing
for drugs, equipment and medical care; coordination of outpatient
managed care program; certification and in-hospital chart review; set
up of home care and follow through case management.

Burgett and Dietrich - (Business closed)-Sept.1989 to Jan. 1992

Review Analyst Nurse responsible for appropriate certification and
utilization review for in-hospital admission of Blue Cross/Blue Shield
members.

Medical Personnel Pool, CareNetwork- Nov. 1988 to Sept 1989

Temporary nursing staff- Assistant Director of Nursing at Nursing
Homes.
Arkansas Children's Hospital neonatal nurse (Neonatal Critical Care
Classes).

Briarwood Nursing Center- Aug.1986 to Nov 1988

As Director of Nursing, I was responsible for providing medical care
and supervising nursing staff at Intermediate Care home with 61
residents.
Ar. Rehab. Institute, Baptist Med System- Apr. 1984 to July 1984
Provided primary nursing for stroke and spinal cord injury patients.

Medical Personnel Pool- Jan. 1982 to Aug. 1986

Hospital staff relief, Private Duty, Home Health Care, Industrial
nurse for Falcon Jet, nurse for the Employee Health Education and
Screening program at Johnson & Johnson (1985).

Ar. Children's Hospital- July 1979 to Jan. 1982

Staff R.N. on Infant/Toddler Unit and Med/Surgical Units.

Charge nurse for outpatient surgery.

L.P.N. Experience
L.P.N. registry- Jan. 1977 to July 1979
Many Private Duty and Hospital staffing assignments including
Aug 1978 to July 1979- Easter Seals Rehab weekend nurse.
July 1978- Ar. Association for Retarded Citizens Camp Nurse
July 1978- Industrial Nurse at Maybelline
Mar. 1977 to July 1978- Live-in Nanny for 3 children
St. Vincent Infirmary- Apr. 1975 to Jan. 1977
Newborn and Neonatal Nursery, Eye surgery and Oncology patient care.

Ar. Children's Colony at Alexander- Nov. 1974 to Mar. 1975

Night shift Charge Nurse for 200+ client residential facility
Jeanne Dixon Hynson, RN, PAHM
15000 Laura Way, Alexander, AR 72002
Home Phone 501-794-1204, Cell Phone 501-909-9527