Itemization Review Nurse II

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES

• Collects supporting data and analyzes information to make decisions regarding accuracy of billing
• Appropriately documents work and final conclusions in designated computer program
• Understanding of Surgical Implants
• Meets department's expectations and standards
• Additional duties as assigned

KNOWLEDGE & SKILLS

• Understanding of Itemization Review for designated clients
• Understanding of CERIS systems and Data Base informatics
• Understanding of HIPAA regulations
• Exceptional organizational skills with the ability to handle stressful situations and adapt accordingly
• Demonstrated leadership skills; ability to work with Leadership Team(s) within a positive team environment
• Strategic problem solving, analytical, and critical thinking skills
• Effective written and verbal communication skills
• Ability to work independently and within a team environment
• Proficiency with Microsoft Office Suite, including Excel, Outlook, Teams

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.
• Associate Degree in Nursing or higher
• Experience in medical bill auditing preferred 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: $61,053 – $98,334

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!).