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Itemization Review Nurse

Fort Worth, TX 76109

CERiS in Fort Worth, Texas is seeking an Itemization Review Nurse. 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 accuracy of charges billed.

About CERiS

CERiS, a division of CorVel Corporation, 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.

DUTIES AND 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

QUALIFICATIONS:

  • 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.
  • 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.

PRODUCTION EXPECTATIONS:

  • Must meet a minimum department volume quota of 275 reviewed claims monthly.
  • Must consistently maintain a less than 2.00% error rate monthly.

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

About CorVel

 

Together, let’s do more.

We are a national provider of risk management solutions for the workers’ compensation, auto, health and disability management industries. We provide our clients with the information and insight they need to make smart decisions. We believe that together, we can deliver better results.

Innovation is our passion.

We invest in intelligent systems and the integrated ecosystem that keeps us all connected. Our commitment to innovation is why we are a nationwide leader in technology driven programs.

We strive for excellence.

With the right mix of savings and customer service, we effectively balance risk and reward. Our expertise and service delivery drive the results your program needs and the savings your bottom line wants.

Our purpose is care.

Every injured worker needs timely, compassionate care. We value your people and we advocate care for your employees. This purpose drives what we do together every day, which is to return injured employees to the workplace.