FIG Services, Inc. P.O. Box 1161 Hendersonville, NC 28793 (828) 698.9486 Ph (828) 698.9327 Fx FIGservices.com Shelene J. Giles MS, BSN, BA, RN, CRC, CNLCP, CLCP, MSCC LICENSURE/CERTIFICATION RN licensure (1995), NC#146238 Certified Life Care Planner (2010), #1090 Medicare Set-Aside Consultant Certified (2005), #0061 Certified Nurse Life Care Planner (2002), #3060415R Certified Rehabilitation Counselor (1991), #00009238 EDUCATION Georgia College, Macon, Georgia August 1995, Bachelor of Science in Nursing, GPA: 3.6. Fort Valley State College, Fort Valley, Georgia December 1991, Master of Science in Rehabilitation Counseling, GPA: 4.0. Piedmont College, Demorest, Georgia August 1989, Bachelor of Arts with double major in Counseling Psychology & Business Administration, GPA: 3.6. PROFESSIONAL EXPERIENCE April 2002 to Present FIG Services, Inc., Hendersonville, NC Nurse Life Care Planner, Medicare Set-Aside Allocator, Case Manager, Expert Witness, Consultant, and Nurse Instructor Complete Nurse Life Care Plans to identify future medical and nonmedical needs for individuals sustaining catastrophic or complicated injuries/illnesses. (Specializing in life care plans for individuals with catastrophic burns.) Develop Medicare Set-Aside allocations and provide submission to Center for Medicare and Medicaid Services (CMS) in accordance with Medicare Secondary Payor Act. Complete Medical Cost Projections for setting reserves/resolving claims. Complete complex Medical File Reviews and Life Care Plan Reviews/ Critiques. Provide case management services to the disabled and aging population within western North Carolina. Service as medical-legal consultant and expert witness (state and federal court) regarding the above mentioned roles. Teach courses (live and webinar) related to nurse life care planning for certification and continued education. Teach Medicare Set-Aside courses (live and webinar) for certification and continued education. Provide mentoring for those in the above mentioned roles. Referral resources include insurance carriers, attorneys, employers, and client/family members.
August 2001 to August 2004 Ability Services Network, Duluth, Georgia Complex Care Unit Manager*, Nurse Life Care Planner, Medicare Set-Aside Allocator, Case Manager, and Ergonomics Consultant Developed/managed/supervised Complex Care Unit consisting of Nurse Life Care Planners providing catastrophic services. Completed Life Care Plans to identify future medical and vocational needs for individuals sustaining catastrophic or complicated injuries/illnesses. Developed Medicare Set-aside allocations on eligible clients. Completed Medical Cost Analysis and Medical Cost Projections for setting reserves/ resolving claims. Completed complex Medical File Reviews and Life Care Plan Reviews/Critiques. Provided legal nurse consulting to assist in identification/resolution of legal claims. Provided case management services (medical and vocational) to industrially injured employees including catastrophic claims in accordance to the North Carolina Industrial Commission laws. Also, provided case management services to clients receiving long-term disability insurance as well as clients involving medical insurance and auto liability claims. Ergonomic and medical file review consulting to determine causality of workers compensation claims and provide appropriate recommendations to assist in claim resolution. Ergonomic/work injury prevention programs with employers. Referral resources included insurance carriers, attorneys, employers, and physicians. *2002 2004. March 2001 to August 2001 Wright Rehabilitation Services, Roswell, Georgia Case Manager Completed Life Care Plans to identify future medical and vocational needs for individuals sustaining catastrophic or complicated injuries/illnesses. Completed Medical Cost Analysis and Medical Cost Projections for setting reserves/resolving claims. Completed complex Medical File Reviews and Life Care Plan Reviews/Critiques. Provided case management services (medical and vocational) to industrially injured employees including catastrophic claims in accordance to the North Carolina Industrial Commission laws. Also, provided case management services to clients receiving long-term disability insurance as well as clients involving medical insurance and auto liability claims. Referral resources included insurance carriers, attorneys, employers, and physicians. February 1996 to February 2001 Concentra Managed Care, Inc., Asheville, North Carolina Case Manager (October 1999 to February 2001) Completed Life Care Plans to identify future medical and vocational needs for individuals sustaining catastrophic or complicated injuries/illnesses. Completed Medical Cost Analysis and Medical Cost Projections for setting reserves/resolving claims. Completed complex Medical File Reviews and Life Care Plan Reviews/Critiques. Provided case management services (medical and vocational) to industrially injured employees including catastrophic claims in accordance to the North Carolina Industrial Commission laws. Also, provided case management services to clients receiving long-term disability insurance as well as clients involving medical insurance and auto liability claims. Ergonomic and medical file review consulting to determine causality of workers compensation claims and provide appropriate recommendations to assist in claim resolution. Ergonomic/work injury prevention programs with employers. Referral sources included insurance carriers, attorneys, employers, and physicians. Job Club Supervisor (Dec 1998 to Oct 1999) Responsibilities included supervision of 8 employees and marketing of North Carolina Job Clubs. Job Club is an intensive, aggressive vocational program to assist injured workers in returning to work in accordance with the North Carolina Industrial Commission guidelines. Giles 2
Senior Supervisor/Manager (Jan 1998 to Dec 1998) Responsibilities included same as Case Management Supervisor as well as supervision of clerical staff. Tracked/projected office production and revenue. Developed strategies to improve quality. Conducted performance reviews and evaluated individual progress as well as set individual/office goals. Expanded Job Club and case management staff. Involved with marketing and identifying prospects resulting in referral growth. Supervisor (October 1997 to January 1998) Responsibilities included daily supervision of case management and Job Club staff. Assured Case Managers performed action-oriented case management which resulted in positive file resolution, compliance with state workers¹ compensation guidelines, met diary dates and billing requirements, adhered to QSI (Quality Service Instructions) guidelines, and captured cost savings. Provided creative, problem solving with Case Managers. Assisted in development of Job Club in western NC. Conducted ergonomic/work injury prevention programs with employers. Facilitated positive relationship with accounts. Promoted positive morale/teamwork among staff. Case Manager (February 1996 to January 1998) Provided case management services (medical and vocational) to industrially injured employees including catastrophic claims in accordance to the North Carolina Industrial Commission laws. Also, provide case management services to long-term disability clients and clients involving auto liability claims. Referral sources included insurance carriers, attorneys, employers, and physicians. July 1993 to February 1996 Intracorp, Norcross, Georgia Rehabilitation Counselor/Case Manager Provided rehabilitation services (medical and vocational) to industrially injured employees (catastrophic & noncatastrophic) in accordance to the Georgia State Board of Workers Compensation laws. Also, provided rehabilitation services to long-term disability clients and clients involving auto liability claims. Referral sources included insurance carriers, attorneys, and employers. August 1992 to July 1993 Lashley Rehabilitation Services, Macon, Georgia Rehabilitation Counselor/Case Manager Provided rehabilitation counseling services (medical and vocational) to industrially injured employees in accordance to the Georgia State Board of Workers¹ Compensation laws. Conducted vocational evaluations, transferable skills analysis, and generated labor market information for the purpose of vocational expert testimony regarding Social Security Disability claims. Referral sources included insurance carriers, attorneys, employers, and Social Security Administration. October 1991 to January 1992 Georgia Division of Rehabilitation Services, Macon, Georgia Rehabilitation Counselor (Internship) Counseled mentally and/or handicapped clients and assisted in qualifying for appropriate rehabilitation programs in preparation for employment. Directly involved with intake interviews, referrals, counseling and guidance, developing rehabilitation plans, case closures, Job Club, job placement, independent living and supportive employment programs. Giles 3
October 1989 to October 1991 Goodwill Industries, Macon, Georgia Case Manager (November 1990 to October 1991) Coordinated, oriented, documented, reviewed and reported work evaluation, work adjustment and sheltered employment services deemed necessary for all handicapped clients referred to the facility for services. Responsible for direct supervision of all clients (50-75) and coordination of work stations with work adjustment instructors (8-12) in which clients were placed. Work Adjustment Instructor (October 1989 to November 1990) Developed and implemented individual training plans which strengthened the social, personal and working habits/skills of clients ranging in disabilities. Promoted to Case Manager. PROFESSIONAL ASSOCIATIONS American Association of Nurse Life Care Planners (AANLCP), 2002 present Officer: Past President, 2009 Officer: President, 2008 Officer: President Elect, 2007 Scope of Practice Committee, 2009 2010 Standard of Practice Committee, 2007 2008 Core Curriculum Committee, 2006 2009 Journal Committee, 2003 2004 American Association of Legal Nurse Consultants (AALNC), 2007 present North Carolina Nurses Association (NCNA), 2007 present American Nurses Association (ANA), 2007 present American Burn Association (ABA), 2006 present International Society for Burn Injuries, 2010 present National Alliance of Medicare Set-Aside Professionals (NAMSAP), 2007 present National Nurses in Business Association (NNBA), 2008 present International Association of Rehabilitation Professionals (IARP), 1996 2007, 2010 - present International Academy of Life Care Planners (IALCP), 2003 2007, 2010 present Association of Certified Life Care Planners (ACLCP), 2010 present National Association of Professional Geriatric Care Managers (NAPGCM), 2005 2007 TRAINING October 9-11, 2010 AANLCP 10 th Annual Education Conference, presented by AANLCP, Boston, MA April 17-18, 2010 Life Care Planning Summit 2010, presented by IARP, Atlanta, GA March 19-20, 2010 Association of Certified Life Care Planners Spring Congress/Conclave, presented by ICHCC, Orlando, FL September - December, 2009 Life Care Planning Educational Course (120 hours), presented by University of Florida October 9-12, 2009 AANLCP 9 th Annual Education Conference, presented by AANLCP, Denver, CO Giles 4
September 31 - October 1, 2009 4 th Annual Meeting & Education Conference, presented by NAMSAP, Las Vegas, NV September 24-26, 2009 Symposium on Life Care Planning, presented by IARP, Chicago, IL October 2, 2008 4 th Annual Meeting & Education Conference, presented by NAMSAP, Washington, DC September 14-17, 2008 AANLCP 8 th Annual Education Conference, presented by AANLCP, San Diego, CA February 29 - March 1, 2008 ABNS Spring Assembly Meeting, presented by American Board of Nursing Specialties, Long Beach, CA December 5, 2007 Forensic Nursing: The Patient, the Crime Scene, presented by Maria Farmer/PESI, Asheville, NC November 2-4, 2007 20 th Annual Southern Region Burn Conference, presented by Southern Medical Association/American Burn Association, Augusta, GA September 23-26, 2007 AANLCP 7 th Annual Education Conference, presented by AANLCP, Orlando, FL October 14-15, 2006 International Association of Life Care Planning, presented by MediPro Seminars, Atlanta, GA October 12-13, 2006 Advanced Burns Program, presented by MediPro Seminars, Atlanta, GA September 20-23, 2006 AANLCP 6 th Annual Education Conference, presented by AANLCP, Nashville, TN December 8-11, 2005 Geriatric Care Managers & National Association of Elder Law Attorneys Joint Conference, presented by NAPGCM, Tucson, AZ October 8-9, 2005 Advanced Medicare Set-Aside Program, presented by MediPro Seminars, Atlanta, GA September 8-10, 2005 AANLCP 5 th Annual Education Conference, presented by AANLCP, San Francisco, CA 2005-2006 Elder Care Management Program (Module 1, 2, 3, 4, 5, 6, 7) presented by The University of Florida/MediPro Seminars June 23-25, 2004 Medicare Set-Aside Program, presented by The University of Florida/MediPro Seminars, Atlanta, GA Giles 5
September 11-13, 2003 AANLCP 3rd Annual Education Conference, presented by AANLCP, Las Vegas, NV June 21-22, 2003 Medicare Set-Aside Program, presented by The University of Florida/MediPro Seminars, New Orleans, LA September 12-14, 2002 AANLCP 2 nd Annual Education Conference, presented by AANLCP, San Antonio, TX March 7-13, 2002 Setting The Standards In Life Care Planning (7 day course for CNLCP certification), presented by Kelynco, Long Beach, CA PRESENTATIONS Medicare Set-Aside, MSCC Certification/Renewal Course, October 8, 2010, Boston, MA Long Term Implications of Catastrophic Burns, AALNC National Education Conference, March 24, 2010, Pittsburgh, PA MSA Coding, University of Florida Advanced MSA Program, March 20, 2010, Orlando, FL Down the Road: A Burn Survivor s Journey, Joseph M. Still Burn Center Symposium, March 15, 2010, Atlanta, GA MSA Updates 2009, AANLCP 9 th Annual Education Conference, October 11, 2009, Denver, CO Developing the Cerebral Palsy Plan, AANLCP 9 th Annual Education Conference, October 10, 2009, Denver, CO Nursing Process ~ LCP Foundation, AANLCP 9 th Annual Education Conference, October 9, 2009, Denver, CO Building Foundations for Life Care Plan Development, Panel Discussion, IARP Symposium, September 25, 2009, Chicago, IL Nursing Process = LCP Foundation, IARP Symposium, September 24, 2009, Chicago, IL Your Journey Begins, Heritage Hall International School Commencement Guest Speaker, May 28, 2009, Hendersonville, NC Are You Ready For Absolute Medicare Compliance? North Carolina Advocates for Justice, May 1, 2009, Atlanta, GA Medicare Set-Aside Education Course webinar, FIG Services, Inc., March 2 5, 2009 Lien Resolution: The Ultimate 2009 Update, Georgia Trial Lawyers Association, February 25, 2009, Atlanta, GA Medicare Set-Aside Education Course webinar, FIG Services, Inc., November 3-6, 2008. MSA Updates 2008, AANLCP 8 th Annual Education Conference, September 16, 2008, San Diego, CA Giles 6
Developing a Life Care Plan for Pediatric Catastrophic Burns, AANLCP 8 th Annual Education Conference, September 16, 2008, San Diego, CA Keynote Presentation: Catch the Wave, A Decade of Empowering Nurse Life Care Planners, AANLCP 8 th Annual Education Conference, September 15, 2008, San Diego, CA Medicare Set-Aside Education Course, AANLCP 8 th Annual Education Conference, September 14, 2008, San Diego, CA Medicare Set-Aside Education Course webinar, FIG Services, Inc., July 28 31, 2008 Medicare Set-Aside Education Course webinar, FIG Services, Inc., March 31 April 3, 2008 Medical Cost Projections & Life Care Plans for the Catastrophic Case, Comprehensive Care Group, February 12, 2008, Atlanta, GA Medicare Set-Aside Education Course webinar, FIG Services, Inc., February 4 7, 2008 Medicare Set-Asides, The Garretson Firm Lien Resolution Center, January 11, 2008, Charlotte, NC Creative Case Management & Life Care Plans, Western Carolina Safety Council, October 9, 2007, Asheville, NC Medical Coding, AANLCP 7 th Annual Education Conference, September 25, 2007, Orlando, FL Medicare Set-Aside Updates, AANLCP 7 th Annual Education Conference, September 23, 2007, Orlando, FL Medicare Set-Aside, MSCC Certification Course, August 23, 2007, Salt Lake City, UT Burns/Setting The Standards In Life Care Planning, NLCP Education Course, August 20, 2007, Salt Lake City, UT Medicare Set-Aside, MSCC Certification Course, March 29, 2007, Asheville, NC Burns/Setting The Standards In Life Care Planning, NLCP Education Course, March 26, 2007, Asheville, NC Chronic Pain/Setting The Standards In Life Care Planning, NLCP Education Course, March 23, 2007, Asheville, NC Medicare Set-Aside, MSCC Certification Course, January 11, 2007, Long Beach, CA Burns/Setting The Standards In Life Care Planning, NLCP Education Course, January 9, 2007, Long Beach, CA Medicare Set-Aside Updates, AANLCP 6 th Annual Education Conference, September 20, 2006, Nashville, TN Medicare Set-Asides, AANLCP 5 th Annual Education Conference, September 8-10, 2005, San Francisco, CA Avoiding the Pitfalls of Orthopedic Injuries, The Charlotte Workers Comp Update 2003, March 18, 2003, Charlotte, NC Giles 7
Multiple presentations to adjustors/employers/attorneys/physicians, 1996 to present, Topics: Life Care Planning, Medical Cost Projections, Medicare Set-Aside Allocations, Case Management and Ergonomics PUBLICATIONS Acknowledged contribution to American Association of Nurse Life Care Planners Scope of Practice, 2010. Acknowledged contribution to Association of Certified Life Care Planners Standards & Guidelines revision, March 19-20, 2010. Acknowledged contribution to Riddick-Grisham, S. The Role of the Nurse Case Manager in Life Care Planning, In R. Weed & D. Berens (Eds.) Life Care Planning and Case Management Handbook, 3 rd ed. Boca Raton, FL: CRC Press, 2010. Nurse Life Care Planning. Getting It Right. Integrity Newsletter. First Quarter 2008. Acknowledged contribution to American Association of Nurse Life Care Planners Standards of Practice, 2008. Acknowledged contribution to American Association of Nurse Life Care Planners Code of Professional Ethics and Conduct for Nurse Life Care Planners with Interpretative Statements, 2008. Acknowledged contribution to American Association of Nurse Life Care Planners Membership Guide, 2008. Burns. Journal of Nurse Life Care Planning. Volume 7. Number 1. March 2007. Life Care Plan for the Burn Survivor. Getting It Right. Integrity Newsletter. First Quarter 2007. Medicare Set-Aside Allocations in 2006. Journal of Nurse Life Care Planning. Volume 6. Number 2. November 2006. last updated 01/01/11 Giles 8