Itemization Bill Review Supervisor

CorVel Career Site•Fort Worth, TX

1d•Remote

About The Position

The Itemization Review Supervisor will maintain a positive team building approach with emphasis on reporting, leadership and professional communication with all CERIS departments. This is a remote position. 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!).

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.
Must have a minimum of 3 years’ experience in LIBR.
Must have 3 years or Hospital Supervisor/Manager experience
Associate Degree in Nursing or higher
Knowledge of ICD-10, DRG and coding required

Nice To Haves

Preferred but not mandatory
Experience in medical bill auditing, preferred but not mandatory

Responsibilities

Maintain all data and analytics information to make critical decisions and accurate results
Maintain all appeals from all clients as required
Knowledge of and understanding all departmental policies and procedures as they relate to Itemization Review
Advance knowledge of Client Payment Policy for reviews
Knowledge of Quality Control processes as needed
Fully understands process of assigning files and assessing nurse’s queues continually
Fully understands the priority of all claims daily
Maintains monthly matrix reporting
Knowledge of CERiS systems and Data Base informatics
Maintain teams with minimum assistance from manager
Create a team by promoting a positive work environment
Additional duties/responsibilities as assigned by manager
Comply with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program (“IIPP”), as well as, maintain HIPAA compliance