Mid Level Clinical Case Review Jobs

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.

This is a remote position.

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

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.

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Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.