AIRMED INTERNATIONAL
Clinical Resource Utilization Nurse
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Job Description
Insurance Verification and Resource Utilization Nurse
Immediate Supervisor: Clinical Coordinator Manager Director
Department: Medical Operations
Employment Qualifications:
- Must hold a valid nursing license from the County and/or State(s) of primary practice and/or clinical oversight as required for all US-based operations.
- Advanced practice experience and education preferred.
- Minimum of three years clinical experience in an inpatient setting. Case Management experience is preferred.
- Minimum of one year experience in insurance authorization, billing, and/or coding.
- Excellent and effective interpersonal, verbal, and written communication skills.
- Ability to work independently and make decisions.
- Must obtain a certification in case management within two years or other approved advanced certification.
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Basic Functions:
Insurance Functions:
- Obtains prior authorization and insurance verification for medical air/ground transport.
- Maintains fluency in data entry using ICD-10 and CPT Codes.
- Provides excellent customer service, written communication, and computer skills.
- Multitasks and communicates efficiently in a fast-paced environment.
- Maintains a high level of organizational skills with exceptional attention to detail.
Clinical Functions:
- Utilizing a collaborative process, the clinical coordinator assesses, plans, and facilitates the options and services required to meet an individual’s health needs, using communication and available resources to promote quality, cost-effective outcomes.
- Identifies appropriate providers and facilities throughout the continuum of services (as needed) while ensuring that available resources are being used in a timely and cost-effective manner.
- Maintains fiscal responsibility on AirMed’s behalf and serves as an advocate for the patient in all aspects of the transport.
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This is a Hybrid position. At least one day in office.
EEO Statement
Global Medical Response and its family of companies are an Equal Opportunity Employer, which includes supporting veterans and providing reasonable accommodations for individuals with a disability.
More Information about this Job
Check out our careers site benefits page to learn more about our benefit options.
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