3 itemization review nurse ii jobs found in Fort Worth, TX

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...

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   KNOWLEDGE & SKILLS: Comprehensive...

The Itemization Review Coordinator is responsible for maintaining a consistent workflow by distributing claims to Quality Control and Itemization Review Nurses. Keep track of current volume on an individual basis to ensure even distribution throughout department. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Monitor incoming and existing claims and distribute to staff based on priority and due date Maintain and update departmental spreadsheets and attendance calendar per supervisor request Ensure an even and fair distribution of claims to staff Notify staff of priority claim assignments Notify supervisor(s) of claims requiring/receiving extensions Notify supervisor(s)/management of back log files, late files, low census, and waiting list Update SharePoint website as required Assist supervisor(s)/management to identify potential issues in a pro-active manner Maintaining/updating/assisting with all New Hire documentation/packets...