Deborah Prosser
About Deborah Prosser
Deborah Prosser is a Clinical Appeals Nurse Case Manager at Scripps Health in the Greater San Diego Area. She has extensive experience in nursing management and case management, having worked in various healthcare roles since 2004.
Company
Deborah Prosser is currently working at Scripps Health in the Greater San Diego Area. She holds the position of Clinical Appeals Nurse Case Manager, where she manages system-wide utilization review for five hospitals in collaboration with two other RN/Case Managers. Her role involves overseeing inpatient/observation stays and other denied services, including surgical procedures and chemotherapy.
Title
Deborah Prosser serves as a Clinical Appeals Nurse Case Manager. Her current responsibilities at Scripps Health entail performing DRG clinical validation reviews in conjunction with Coding to review medical records requested by third-party auditors. This work aims to decrease potential denials post service.
Education and Expertise
Deborah Prosser earned a Bachelor's degree in Registered Nursing/Registered Nurse from the University of Phoenix between 2003 and 2005. Prior to that, she achieved an Associate's degree in Registered Nursing/Registered Nurse from Grossmont College, completing her studies there from 1982 to 1984. Her educational journey began at El Capitan High School, where she studied from 1975 to 1979.
Background
Deborah Prosser has a diverse background in healthcare management and nursing. She has previously worked as Manager at Care 1st Health Plan, where she oversaw Outpatient Services, UM Quality, CCS, Home Health, and Clinical Retro Claims. She also served as Director of Nursing at La Mesa Healthcare Center and as Director of Staff Development/Interim Director of Nursing at Vi at La Jolla Village Care Center. Earlier in her career, she was a Case Manager at Sharp HealthCare and an MDS Coordinator/ADON at Villa Las Palmas Healthcare Center.
Achievements
Throughout her career, Deborah Prosser has achieved significant success in appeals to HMOs and PPOs, leading to an expanded scope of appeals for audits to include outpatient services. Additionally, she assists with clinical reviews for litigation to pursue reimbursement for inappropriately denied cases.