Itemization Review Nurse II

CERIS; Fort Worth (TX); On-site; USD 61,000 - 98,000; Full time

Benefits offered by this job

Medical (HDHP) w/ Pharmacy

Dental & Vision

Life Insurance

401K & Roth 401K

Parking & Transit

Job summary

CERIS, a division of CorVel, seeks an Itemization Review Nurse to summarize and analyze charges billed to ensure accuracy. You will collect data, review UBIB submissions, and document conclusions within our systems.

The role requires RN licensure in the state, 5+ years in OR/ICU/ER, and strong analytic and communication skills; surgical implants knowledge is a plus. Competitive benefits accompany full-time employment.

Qualifications

• Must maintain current RN licensure in the state of employment.
• Minimum 5 years' experience in the O.R., ICU, or ER as an RN.
• Associate degree in Nursing or higher.
• Experience in medical bill auditing preferred but not mandatory.

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.

Skills

Itemization Review

CERIS systems

HIPAA regulations

Organizational skills

Leadership

Problem solving & analytics

Communication skills

Teamwork

MS Office (Excel/Outlook/Teams)

Education

RN license (state)

Associate Degree in Nursing

Tools

CERIS systems

Database informatics

MS Office Suite

Job description

Description

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.

Job Details

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
• Met 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

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

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.