Yashira Wilson

Motivated registered nurse with 4 years experience on a cardiovascular intensive care unit, progressive cardiac care unit, and One Call services. Graduated from Florida State College of Jacksonville. Self motivated individual with a positive attitude excited about progression and helping to build with teams and patients!

Baptist Medical Center 2018-current

• Collaborates with physicians, nurses, families, patients, adminstration and other health care providers to effectively and professionally communicate information 
• Provides competent and compassionate care that results in a high level of patient satisfaction
• Demonstrates critical thinking skills, scientific judgment, and organizational skills. Prioritizes tasks and adjusts priorities when necessary. Maintains an orderly, efficient and timely flow of patients.
• Utilizes the assessment, identifies problems, makes nursing diagnoses, formulates goals, teaching plans and outcomes to create an individualized plan of care
• Practices autonomously, consistent with practice standards and research based policy/procedures
• CVICU nurse responsible for critical life care to patients

• Team Lead Trainer for Claims Utilization Review department 
• Expert review and authorization through phone and electronic communication for payment requests per established criteria, while meeting compliance standards and timeframes
• Review all requests not approved by the non-clinical support rep to determine in network coverage and repayment regarding ICD-9 and ICD-10 codes
• Assist the Prior Authorization non-clinical representatives with the Prior Authorization process
• Coordinate and maintain complete written documentation on all prior authorizations requests.
• Collaborate with other Florida Blue departments, such as Claims, UM, Quality, Disputes/Appeals, and other external vendors

• Florida State College at Jacksonville Nursing graduate 12/2018 License #9503900
• St. Johns River Community College, Associate in Arts Degree
• Currently enrolled and Florida State College at Jacksonville for Bachelors Degree