Air Medical Group Holdings

  • Resource Utilization Supervisor

    Job Locations US-MO-West Plains
    Posted Date 2 months ago(5/3/2018 9:12 AM)
    iCIMS Requisition ID
    2018-4322
    # of Openings
    1
    Job Families (Portal Searching)
    Resource Utilization
  • Overview

    This position provides the direct over-sight management of the Resource Utilization RN’s.

     

    Responsibilities

    • RU RN Coding process
      • Function as a resource to the RN coders.
      • Oversees the RU RN oding orientation process.
      • Conduct reviews and provide feedback to the Department Manager on the individual RU RN’s productivity and accuracy.
      • Communicate any and all changes on the determination of medical necessity, closest appropriate or ground transport coding by Level of Service per Payer grouping.
      • Facilitate the transition to ICD-10 coding and continue the current management of the selection of the ICD-9’s to the highest level of specificity in the proper order/priority.
      • Updates the RU RNs with the latest information; web resources for Industry Standards regarding:
        • National Standards of Care
        • Professional National Organization Position Papers (AMPA; NAEMSP; AMTC, CAAS, CAMTS)
        • Corporate Medical Director Position Papers (requires a close working relationship with all clinical departments from each AMGH Company)
        • Published research articles on the HEMS industry.
        • Published articles / research on critical care / ED care.
        • Payer Publications, references related to billing level of service (Medicare; Medicaid; VA; Commercial Insurances)
      • Works closely with the Verification Manager and Systems Director on process flow and communication with the Verification team.
    • Medical Necessity Appeals
      • Department Manager and Department Supervisor receive monthly reports on appeal data (monies collected and numbers mailed) and evaluate for feedback to the team.
      • Assures timeliness of appeal mailing.
      • Functions as the first line resource to the RU RNs on appeals for all payer groups.
      • Oversees the RU RN appeals orientation process.
    • Department General Duties:
      • Payroll
      • Scheduling
      • Special project coordination / assignment
      • Oversight of all work flow processes
    • Function as a resource and assist the Department Manager in:
      • Department Compliance reports
      • Special Audit projects from payer sources
      • Staffing needs
      • Budget preparation
      • Human Resource topics
      • Annual Evaluations
      • Staff Meetings
      • Due Diligence process assignments
      • Other duties as assigned

    Qualifications

    • Education:
      • Current RN licensure in state of residence
      • Current Certification as an Ambulance Coder (NAAC   
    • Skills:
      • Ability to dine problems, collect data, establish facts, and draw valid conclusions
      •  Ability to respond to inquires or complaints from customers in a positive and productive manner
      • Ability to critically think and set priorities. 
    • Experience:
      • Minimum of Five years of Emergency Department (ED) or Intensive Care Unit (ICU) or Flight Nursing experience OR current / recent experience or job experience equivalent.
      • Resource Utilization RN for a minimum of 2 years.
      • Two years previous management/leadership experience
    • WORKING CONDITIONS AND PHYSICAL REQUIREMENTS
      • Duties require the employee to regularly reach with hands and arms; speak and hear
      • Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus

    An Equal Opportunity Employer: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

     

    Time Type (Portal Searching)

    Regular Full-Time

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