Itemization Review Nurse II

CERIS; Fort Worth (TX); Remote; USD 59,000 - 97,000; Full time

Job summary

CERIS is seeking an Itemization Review Nurse II to analyze medical billing accuracy based on UBIB submissions. The role is remote and requires RN licensure along with experience in O.R., ICU, or E.R. Candidates will collect data, analyze charges, and collaborate within a supportive team to ensure compliance and accuracy in healthcare payments. Join a dedicated company committed to excellence and career advancement opportunities.

Benefits

Comprehensive benefits package

401K and ROTH 401K options

Paid time off

Medical, Dental, and Vision insurance

Qualifications

• Current RN licensure in Texas required.
• Minimum 5 years experience in O.R., ICU, or E.R.
• Experience in medical bill auditing preferred.

Responsibilities

• Analyze and review charges submitted on UBIB for accuracy.
• Document findings in the designated computer program.
• Work collaboratively within a team environment.

Skills

Organizational skills

Critical thinking

Effective communication

Leadership

Problem solving

Education

Associate Degree in Nursing

Tools

Microsoft Office Suite

Excel

Outlook

Skype for Business

Job description

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Description

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

Job Details

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

This is a remote position.

Essential Functions & Responsibilities

• Collect supporting data and analyze information to make decisions regarding accuracy of billing.
• Appropriately document work and final conclusions in designated computer program.
• Understanding of Surgical Implants.
• Understanding of CERiS systems and Data Base informatics.
• Capability to meet department expectations and standards.
• Be a team player working with Leadership Team(s) within a positive team environment.
• Additional duties/responsibilities as assigned.
• Comply with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program (“IIPP”), as well as, maintain HIPAA compliance.

Knowledge & Skills

• 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 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.
• Associate Degree in Nursing or higher.
• Experience in medical bill auditing, preferred but not mandatory.
• Coding certification is preferred but not mandatory (CPC, CCS, CIC, CPMA).
• Experience working in a Remote (Work from home) position, 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 various factors including experience, qualifications, 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 based on assessment during the interview process. The level may impact the salary range, which would be clarified during the offer process.

Pay Range: $59,681 – $96,123

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management.

Our opportunities will be posted for up to 1 year from the date of posting or until we have selected candidate(s), whichever comes first.

About Ceris

CERIS, a division of CorVel Corporation, offers value, experience, and dedication to our partners. Through 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 supportive culture and career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity, and Teamwork (ACE-IT!).

Our full-time employees enjoy a comprehensive benefits package including Medical (HDHP) w/Pharmacy, Dental, Vision, Disability, HSA, FSA, Life Insurance, Accident & Critical Illness Insurance, Legal Insurance, Parking and Transit FSA, 401K, ROTH 401K, and paid time off.

Equal Opportunity Statement

CorVel is an Equal Opportunity Employer, drug-free workplace, and complies with ADA regulations as applicable.