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!).

Itemization Review Nurse I

Medical ReviewerMedical ReviewerFull TimeRemoteTeam 501-1,000

Location

United States

Posted

89 days ago

Salary

$51.8K - $83.6K / year

No structured requirement data.

Job Description

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

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

  • Comprehensive benefits package for full-time regular employees
  • 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 and 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!).

Job Requirements

  • 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
  • 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

  • Comprehensive benefits package for full-time regular employees
  • 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 and ROTH 401K
  • Paid time off

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