Summary
Overview
Work History
Education
Personal Data
LICENSES
Certification
Timeline
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Mary Grace Balabala

Mary Grace Balabala

Harrisburg

Summary

I am a REGISTERED NURSE with 13 years of experience.

Overview

13
13
years of professional experience
1
1
Certification

Work History

UMR Appeals Clinical Quality Auditor/Case Manager

Optum Global Solutions
12.2019 - 04.2024
  • Assess and audit medical documentation for ensuring compliance and adherence to guidelines.
  • Educate the team with opportunities encountered for quality improvement.
  • Analyzing the denials of insurance claims or of coverage for medical treatments or procedures at a healthcare facility.
  • Review medical code data and records to determine whether the denial was warranted or whether to move forward with an appeal.

Dialysis Nurse

JCTM Kidney Care Dialysis
11.2019 - 12.2019


  • Providing pre, intra and post dialysis treatment care for clients with kidney diseases in outpatient setting. Monitor patients throughout treatment and identify unusual reactions.

Nurse Specialist (Pioneer)

King Abdullah bin Abdulaziz University Hospital- Princess Nourah University
08.2014 - 07.2019
  • Responsible for the commissioning phase of areas assigned (Outpatient, Dialysis and Nursery department)
  • Handled patients in the Outpatient Department specialty in Surgery and Nursery department
  • Assigned in Crash Cart committee
  • Undergone different trainings, seminars, courses, OSCES and Up skilling program of KAAUH
  • Specialty training on CRRT (Continuous Renal Replacement Therapy) for both in adult and pedia.

Hemodialysis Nurse

Commonwealth Hospital and Medical Center
05.2012 - 08.2014


  • Providing pre, intra and post dialysis treatment care for clients with kidney diseases in outpatient and inpatient setting. Monitor patients throughout treatment and identify unusual reactions.

General Ward Nurse

Commonwealth Hospital and Medical Center
05.2011 - 05.2012


  • Consult and coordinate with healthcare team members to assess, plan, implement, or evaluate patient care plans
  • Instruct individuals, families, or other groups on topics such as health education, disease prevention, or childbirth and develop health improvement programs
  • Direct or coordinate infection control programs, advising or consulting with specified personnel about necessary precautions
  • Perform clinical tasks
  • Provide High quality inpatient care.

Education

Bachelor of Science in Nursing -

Far Eastern University-NRMF
Quezon City, Philippines
04.2008

Personal Data

Date of Birth: May 02, 1987 

Civil Status: Married 

Citizenship: Filipino

Spoken Language: English / Filipino

LICENSES


  • Commonwealth of Pennsylvania Department of State Bureau of Professional and Occupational Affairs as Registered Nurse License Number: RN730272.
  • Kingdom of Saudi Arabia Prometrics Passser for Saudi Commission for Heath Specialist. Registration Number: 14-R-N-0038498
  • Philippine Registered Nurse License Number: 0507988 from Professional Regulation Commission, Metro Manila Philippines.

Certification

I hereby certify that all information contained herein are true and correct to the best of my knowledge and ability.

Timeline

UMR Appeals Clinical Quality Auditor/Case Manager

Optum Global Solutions
12.2019 - 04.2024

Dialysis Nurse

JCTM Kidney Care Dialysis
11.2019 - 12.2019

Nurse Specialist (Pioneer)

King Abdullah bin Abdulaziz University Hospital- Princess Nourah University
08.2014 - 07.2019

Hemodialysis Nurse

Commonwealth Hospital and Medical Center
05.2012 - 08.2014

General Ward Nurse

Commonwealth Hospital and Medical Center
05.2011 - 05.2012

Bachelor of Science in Nursing -

Far Eastern University-NRMF

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Mary Grace Balabala