Claims Examiner reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Being a Claims Examiner studies reports prepared by adjusters and similar claims to determine the extent of insurance coverage and validity of the claim. Communicates with agents, claimants, and policy holders. Additionally, Claims Examiner determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. The Claims Examiner work is closely managed. Works on projects/matters of limited complexity in a support role. To be a Claims Examiner typically requires 0-2 years of related experience. (Copyright 2024 Salary.com)
Department: Emergency Medicine SVH
Exempt: No
Schedule: VARIABLE
Position Type: Per Diem
FTE: 0.000100
Base Wage $35.82 to $66.24
Location: Skagit Valley Hospital
The information described in this job description has been designed to indicate the general nature of the work performed. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job.
Other information:
Job Summary
Sexual Assault Nurse Examiners (SANE) are Registered Nurses with specialized training in the assessment and care of victims of sexual assault. SANE nurses have specific training and education that focuses on conducting a forensic exam. The SANE RN is involved in every stage of the response to a crime of rape, assault, domestic violence, or battery. This includes assessing the victim, preserving evidence, providing nursing care and emotional support, and testifying in any potential legal proceedings.
Essential Functions
Assessment and Documentation Forensic nurses carefully collect and document evidence about their patient's status, diligently write down patients account of events, collect any physical evidence, or potential DNA evidence, so that it may be used by criminal investigators. Treatment In cases of sexual assault, forensic nurses are responsible for offering immediate help with the prevention of pregnancy (Plan B), and sexually transmitted infection/disease. They also provide the victim with personalized referrals for medical and psychological care. Testimony One of the most important duties of a forensic nurse isn't in the hospital at all, but before a judge. Because a forensic nursing education typically includes instruction in criminal law, forensic nurses can be called upon to testify if a case goes to trial. According to American Forensic Nurses (www.amrn.com), because forensic nurses have training in documentation and evidence preservation, they may be responsible for acting as expert witnesses in a court of law. Continuing Education Forensic nurses should also be well-versed in treatment procedures. Five hours of Continuing education yearly is required in the form of Forensic Nurse(SANE) class/ conference/ CE article/ or online class that may include but not limited to: treatments for assault patients, psychiatric education as well as pathological studies. Availability No cases are to be taken while clocked in as a patient care nurse. Nurses are to be available for 3 days a month, working with the unit manager or scheduler as mutually agreeable. When called they should be able to respond to the hospital within an hour. All Forensic/SANE nurses must have 2 cases a year.
Education
RN licensure, completion of an accredited SANE training program, preferably with Harborview Medical Center within six months of hire.
Experience/Training
Two years recent RN experience.
License/Certifications
Washington State RN License required. American Heart Association BLS required.
Other Skills
Demonstrates ability and appropriate technical skills when administering treatments and procedures in accordance with physician's orders and policies and procedures. Demonstrates ability to handle emergency situations in a prompt, precise, and professional manner. Provides personal patient care to provide comfort and well being to the patient, acknowledging physiological and psychological needs. Strong verbal, written and interpersonal communication skills required.
Physical Demands and Work Environment
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and hear. This position is very active and requires standing, walking, bending, kneeling, stooping, crouching, crawling, and climbing all day. The employee must frequently lift or move objects and patients weighing over 50 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to focus.Skagit Regional Health offers a comprehensive benefit package including medical, dental, vision, 457b/401a (retirement), long term disability, and paid time off to all employees holding an FTE of 20 or more hours per week. Eligible employees also receive sick time pay.
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