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Itemization Review Nurse

Company: CorVel Corporation
Location: Fort Worth
Posted on: January 15, 2021

Job Description:

CERiS in Fort Worth, Texas is seeking an Itemization Review Nurse. The Itemization Review Nurse will provide a Summary and analysis of items by reviewing all charges submitted on a UBIB provided by a medical facility to determine accuracy of charges billed. DUTIES AND 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 QUALIFICATIONS:
  • 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.
  • 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. PRODUCTION EXPECTATIONS:
  • Must meet a minimum department volume quota of 275 reviewed claims monthly.
  • Must consistently maintain a less than 2.00% error rate monthly.

Keywords: CorVel Corporation, Fort Worth , Itemization Review Nurse, Healthcare , Fort Worth, Texas

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