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Role Description

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:

• Collects supporting data and analyzes information to make decisions regarding accuracy of billing.
• Appropriately documents work and final conclusions in designated computer program.
• Understanding of Surgical Implants.
• Meets department's expectations and standards.
• Additional duties as assigned.

Qualifications

• Understanding of Itemization Review for designated clients.
• Understanding of CERIS systems and Data Base informatics.
• Understanding of HIPAA regulations.
• Exceptional organizational skills with the ability to handle stressful situations and adapt accordingly.
• Demonstrated leadership skills; ability to work with Leadership Team(s) within a positive team environment.
• Strategic problem solving, analytical, and critical thinking skills.
• Effective written and verbal communication skills.
• Ability to work independently and within a team environment.
• Proficiency with Microsoft Office Suite, including Excel, Outlook, Teams.

Requirements

• Must maintain current licensure as a 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.
• Associate Degree in Nursing or higher.
• Experience in medical bill auditing preferred but not mandatory.

Benefits

• 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
• Paid time off

Company Description

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!).