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.
ESSENTIAL FUNCTIONS & 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
KNOWLEDGE & SKILLS:
Advance 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
Proficient in scheduling monthly team meetings with emphasis on education
Proficient in MedCheck, MedCheck Select, CareMC, Tableau, UltiPro, Department
Employee Handbook Policy and Procedures, Microsoft Office Suite, Excel,
Outlook, and Skype for Business
EDUCATION & EXPERIENCE:
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. Preferred but not
mandatory
Must have 3 years or Hospital Supervisor/Manager experience
Associate Degree in Nursing or higher
Experience in medical bill auditing, preferred but not mandatory
Knowledge of ICD-10, DRG and coding required but not mandatory
PAY RANGE:
CorVel uses a market based approach to pay and our salary ranges may vary
depending on your location. Pay rates are established taking into account the
following factors: federal, state, and local minimum wage requirements, the
geographic location differential, job-related skills, experience,
qualifications, internal employee equity, and market conditions. Our ranges may
be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into
a different level, either up or down, based on assessment during interview
process taking into consideration experience, qualifications, and overall fit
for the role. The level may impact the salary range and these adjustments would
be clarified during the offer process.
Pay Range: $70,276 – $116,942
A list of our benefit offerings can be found on our CorVel website: CorVel
Careers | Opportunities in Risk Management
[https://www.corvel.com/company/careers/]
In general, our opportunities will be posted for up to 1 year from date of
posting, or until we have selected candidate(s) to fulfill the opening,
whichever comes first.
ABOUT 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!).
A comprehensive benefits package is available for full-time regular employees
and includes 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, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with
ADA regulations as applicable.
#LI-Remote