Hardworking and motivated Registered Nurse with 20 years of experience and record of success in health insurance industry. Solid history balancing team performance, customer service targets and business objectives. Dedicated to working closely with employees to maximize productivity and optimize procedures. Decisive leader with good planning and organizational skills.
· Trained new nursing staff members in the utilization review process
· Led weekly team huddles.
· Conducted monthly RN quality assessments.
· Submitted monthly cost savings report to upper management.
· Initiated correspondence to physicians, suppliers, and facilities requesting additional information to ensure accurate claim review.
· Maintained knowledge of new medical and surgical procedures & products, new drugs as well as changing trends in healthcare delivery.