Quality Control Nurse I

CorVel Career Site•Fort Worth, TX

8d•Remote

About The Position

The Quality Control Nurse is responsible for ensuring and maintaining MCS Bill Review database integrity. Ensures timely application of QC protocols to meet production standards. This is a remote position.

Requirements

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 MedCheck Select V5.0, Microsoft Office Suite, Excel, Outlook, and Skype for Business
Must maintain current licensure as a Licensed Practical Nurse or 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. or 10+ years of patient care in a medical setting
Current license or Associate Degree in Nursing or higher

Nice To Haves

Experience in medical bill auditing, preferred but not mandatory

Responsibilities

Analyses itemization line item descriptors from hospital billing entered
Verifies line item data sets for completeness, correctness and understandability
Maintain the integrity of each provider chargemaster within Scheck
Maintains consistent communications with the Data Entry Analyst on line item entries
Maintains constant communications with the Medical Review Department regarding unusual billing practices and discovery of potential errors
Maintain 100% accuracy of data set(s) PRIOR to moving files to the next department to meet production and turnaround time requirements
Maintain HIPAA compliance in all aspects of communications
Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
Additional tasks as required by Supervisor