Itemization Review Nurse II

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges.

This is a remote position. 

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

• Collect supporting data and analyze information to make decisions regarding accuracy of billing
• Appropriately document work and final conclusions in designated computer program
• Understanding of Surgical Implants
• Understanding of CERiS systems and Data Base informatics
• Capability to meet department expectations and standards
• Be a team player working with Leadership Team(s) within a positive team environment
• Additional duties/responsibilities as assigned
• Comply with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program (“IIPP”), as well as maintain HIPAA compliance

KNOWLEDGE & SKILLS:

• 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 Microsoft Office Suite, Excel, Outlook, and Skype for Business    

EDUCATION & EXPERIENCE:

• Must maintain current licensure as a Registered Nurse in the state of employment
• Must have a minimum of 5 years of recent (within the last 10 years) experience in the O.R., ICU, or E.R. as an R.N.
• Associate Degree in Nursing or higher
• Experience in hospital bill auditing, preferred but not mandatory
• Coding certification is preferred but not mandatory (CPC, CCS, CIC, CPMA).
• Exceptional organizational, strategic and critical thinking skills.

PAY RANGE: 

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:  $61,053 – $98,334 

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. 

#LI-Remote

Salary : $61,053 - $98,334