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!).
Itemization Review Supervisor
Location
United States
Posted
2 days ago
Salary
$70.3K - $116.9K / year
Seniority
Mid Level
No structured requirement data.
Job Description
Itemization Review Supervisor
CERIS
Role Description The Itemization Review Supervisor will maintain a positive team building approach with emphasis on reporting, leadership and professional communication with all CERIS departments. This is a remote position. Essential Functions & Responsibilities: - Maintain accurate, current data and analytics to support informed decision-making and reliable outcomes - Manage and track client appeals as required - Oversee the file assignment process and continuously monitor nurse workloads and queues - Ensure daily prioritization of all claims is clearly understood and executed - Prepare and maintain monthly metrics and reporting - Demonstrate working knowledge of CERIS systems and databases - Lead and support the team with minimal managerial oversight - Foster a collaborative and positive work environment through effective team leadership - Ensure strict adherence to HIPAA compliance standards - Additional duties as assigned Qualifications - Comprehensive knowledge of departmental policies and procedures related to Itemization Review - Advanced understanding of client payment policies as they apply to reviews - Familiarity with quality control processes - Strong organizational, strategic thinking, and critical analysis skills - Excellent written and verbal communication skills - Ability to manage high-pressure situations and adapt to changing priorities - Proven leadership, problem-solving, and analytical capabilities - Ability to work both independently and collaboratively - Skilled in organizing and facilitating monthly team meetings with a focus on training and development - Proficiency in MedCheck, MedCheck Select, CareMC, Tableau, UKGPro, departmental policies and procedures, and Microsoft Office Suite (including Excel, Outlook, and Teams) Requirements - Must maintain current licensure as a Registered Nurse (RN) 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. - At least 3 years of experience in a hospital supervisor or manager role - Associate Degree in Nursing or higher - Minimum of 3 years’ experience in LIBR preferred - Experience in medical bill auditing preferred - Knowledge of ICD-10, DRG and coding preferred Benefits - Comprehensive benefits package available for full-time regular employees - 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 and ROTH 401K - Paid time off Company Description 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!).
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