Call Center Nurse Resume

Samantha Gray

North Highlands CA 95660

(916) 987-6543

[email protected]

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Job Objective

A Call Center Nurse job that allows for the growth of the position within the hospital to develop it as well.

Work Experience:

Call Center Nurse, August 2005 – Present

PeaceHealth, Maryland Heights, MO

  • Provided telephonic advice to members.
  • Ensured adherence to all company policies concerning the preauthorization process.
  • Educated members and providers on the authorization process.
  • Communicated to assigned supervisor all cases needing a higher level of intervention.
  • Documented all pre-certifications and authorization requests.
  • Supervised non-clinical team members.
  • Participated in Quality Improvement processes.

Call Center Nurse, May 2000 – July 2005

Los Alamos Medical Center, Maryland Heights, MO

  • Documented all calls to meet requirements of management and regulatory compliance.
  • Coordinated interdepartmental communication for integration purposes.
  • Assisted members in problem resolution.
  • Conducted initial assessments within designated timeframes on patients identified as having complex case management needs.
  • Prioritized care needs, set goals and developed initial plan of care.
  • Ensured compliance to local, state, and federal laws and regulations.
  • Participated in Ethics and Integrity education programs.

Summary of Qualifications:

  • Outstanding experience in direct patient care within ambulatory setting
  • Deep Knowledgeable in Medicare, JCAHO, and Dept. of Health regulations pertaining to ambulatory care
  • Wide knowledge of the different disciplines and disease states
  • Ability to provide services in an environment that involves multiple health care systems
  • Ability to interact with all relevant components of the health care system
  • Ability to provide services that deal with the individual’s broad spectrum of needs
  • Excellent verbal and written communications skills
  • Strong decision making and telephone skills


Bachelor of Science in Nursing, Midwestern State University, Wichita Falls, TX