Resource Utilization Nurse

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.

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 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 individuals 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 AirMeds behalf and serves as an advocate for the patient in
  all aspects of the transport.
• This is a Hybrid position. At least one day in office.

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.

Check out our careers site benefits page to learn more about our benefit options.