What are the responsibilities and job description for the Quality Control Nurse I position at CERIS?
Job Details
Description
The Quality Control Nurse is responsible for ensuring and maintaining MCS Bill Review database integrity. Ensures timely application of QC protocols to meet production standards.
This is a remote position.
Essential Functions & Responsibilities
CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.
Pay Range: $52,999 – $85,473
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.
ABOUT CERiS
CERiS, a division of CorVel Corporation, a certified Great Place to Work® Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
Description
The Quality Control Nurse is responsible for ensuring and maintaining MCS Bill Review database integrity. Ensures timely application of QC protocols to meet production standards.
This is a remote position.
Essential Functions & Responsibilities
- Analyses itemization line item descriptors from hospital billing entered
- Verifies line item data sets for completeness, correctness and understandability
- Maintain the integrity of each provider chargemaster within Scheck
- Maintains consistent communications with the Data Entry Analyst on line item entries
- Maintains constant communications with the Medical Review Department regarding unusual billing practices and discovery of potential errors
- Maintain 100% accuracy of data set(s) PRIOR to moving files to the next department to meet production and turnaround time requirements
- Maintain HIPAA compliance in all aspects of communications
- Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
- Additional tasks as required by Supervisor
- Exceptional organizational, strategic and critical thinking skills
- Effective and professional communication skills
- Ability to handle stressful situations and adapt accordingly
- Demonstrated outstanding leadership, problem solving, and analytical skills
- Ability to think and work independently, while working in an overall team environment
- Proficient in MedCheck Select V5.0, Microsoft Office Suite, Excel, Outlook, and Skype for Business
- Must maintain current licensure as a Licensed Practical Nurse or Registered Nurse in the state of employment
- Must have a minimum of 5 years’ experience in the O.R., ICU, or E.R. as an R.N. or 10 years of patient care in a medical setting
- Current license or Associate Degree in Nursing or higher
- Experience in medical bill auditing, preferred but not mandatory
CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.
Pay Range: $52,999 – $85,473
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.
ABOUT CERiS
CERiS, a division of CorVel Corporation, a certified Great Place to Work® Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
Salary : $52,999 - $85,473