Itemization Review Manager

CERIS•Fort Worth, TX

3d•$70,276 - $116,942•Remote

About The Position

The Itemization Review Manager is responsible for managing daily production (file flow) of designated department, which may include one or more of the following functions: human resources, customer service, while promoting positive influence over professional review nurses within the EBR Medical Review group.

Requirements

Excellent verbal and written communication skills
Ability to remain poised in stressful situations and communicate diplomatically via different communication channels
Ability to skillfully manage multiple, complex projects and competing priorities concurrently while working under pressure to meet deadlines and maintaining strong customer service orientation
Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets
Thorough understanding of EBR Professional Review Nurse Responsibilities is necessary to accurately perform the functions of this position
Exceptional organizational skills
Associate’s degree and current RN license in the State of Texas required
Experience as a Itemization Review Nurse for a minimum of 1 year

Nice To Haves

Bachelor’s or Master’s degree in nursing preferred
Previous supervisory experience a plus
Additional certifications in nursing, business management and medical bill review preferred

Responsibilities

Responsible for managing the daily file flow coming into Medical Review while maintaining awareness of potential file flow from other departments to track rush or special files, test files, or pilot studies for prospective clients
Writing performance evaluations for direct report staff for approval by EBR Manager on annual basis in accordance with company best practices
Responsible for quality of SOA review results for trainee-approved files; keeping own error ratio to less than 2% minimum on all approved files checked per month
Responsible for human resources matters directly related to department staff under direct supervision, including documentation of events or occurrences and verbal mentoring direct report staff when attendance or performance deficiencies are discovered
Responding to inquiries from internal customers within established time frame and indicating within the response when inquiry has been escalated and resolved by EBR Manager, directing further inquiries regarding the subject to the EBR Manager
Analyze data trends and daily counts to effectively manage workflow for nursing staff, and to respond correctly to questions received by the department from other CorVel offices, including account managers, upper management, and interdepartmental units within the Fort Worth office
Track the attendance of staff under direct supervision, in addition to ensuring adequate staffing levels during holiday seasons and peak times
Must be able to correctly respond to any on the job injury reported by staff members, and have thorough knowledge of the process for documentation and reporting in accordance with company procedures
Assist EBR Manager with their duties as needed
Assist with scheduling and initial screening of candidates for open positions, reporting on prospects to EBR Manager and submitting notes to assist EBR Manager in their final hiring decision
Participate in provider calls and meetings for designated clientele
May be required to travel overnight and attend meetings or training of various nurses in EBR Medical Review
May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses as directed by EBR Manager with assigned completion dates
Additional duties as assigned