Job details
JobDescriptionJobDescriptionThe Itemization Review Supervisorwill maintain a positive team building approach with emphasis onreporting, leadership and professional communication with all CERISdepartments.ESSENTIAL FUNCTIONS& RESPONSIBILITIES:Maintain all data and analyticsinformation to make critical decisions and accurateresultsMaintain all appeals from all clientsas requiredKnowledge of and understanding alldepartmental policies and procedures as they relate to ItemizationReviewAdvance knowledge of Client PaymentPolicy for reviewsKnowledge of Quality Controlprocesses as neededFully understands processof assigning files and assessing nurse's queuescontinuallyFully understands the priority ofall claims dailyMaintains monthly matrixreportingKnowledge of CERiS systems and DataBase informaticsMaintain teams with minimumassistance from managerCreate a team bypromoting a positive workenvironmentAdditional duties/responsibilitiesas assigned by managerComply with all safetyrules/regulations, in conjunction with the Injury and IllnessPrevention Program ("IIPP"), as well as,maintain HIPAA complianceKNOWLEDGE &SKILLS:Advance organizational, strategic andcritical thinking skillsEffective andprofessional communication skillsAbility tohandle stressful situations and adaptaccordinglyDemonstrated outstandingleadership, problem solving, and analyticalskillsAbility to think and workindependentlyProficient in scheduling monthlyteam meetings with emphasis oneducationProficient in MedCheck, MedCheckSelect, CareMC, Tableau, UltiPro, Department Employee HandbookPolicy and Procedures, Microsoft Office Suite, Excel, Outlook, andSkype for BusinessEDUCATION &EXPERIENCE:Must maintain current licensure as aRegistered Nurse in the state ofemploymentMust have a minimum of 5years' experience in the O.R., ICU, or E.R. as anR.N.Must have a minimum of 3 years'experience in LIBR. Preferred but notmandatoryMust have 3 years or HospitalSupervisor/Manager experienceAssociate Degreein Nursing or higherExperience in medical billauditing, preferred but not mandatoryKnowledgeof ICD-10, DRG and coding required but notmandatory INT
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Hiring company
Confidential
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