Utilization Review Nurse

Itemization Review NurseThe 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 & ResponsibilitiesCollects supporting data and analyzes information to make decisions regarding accuracy of billingAppropriately documents work and final conclusions in designated computer programUnderstanding of Surgical ImplantsMeets department's expectations and standardsAdditional duties as assignedKnowledge & SkillsUnderstanding of Itemization Review for designated clientsUnderstanding of CERIS systems and Data Base informaticsUnderstanding of HIPAA regulationsExceptional organizational skills with the ability to handle stressful situations and adapt accordinglyDemonstrated leadership skills; ability to work with Leadership Team(s) within a positive team environmentStrategic problem solving, analytical, and critical thinking skillsEffective written and verbal communication skillsAbility to work independently and within a team environmentProficiency with Microsoft Office Suite, including Excel, Outlook, TeamsEducation & ExperienceMust maintain current licensure as a Registered Nurse in the state of employmentMust have a minimum of 5 years' experience in the O.R., ICU, or E.R. as an R.N.Associate Degree in Nursing or higherExperience in medical bill auditing preferred but not mandatoryPay RangeCorVel 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 – $98,334A 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.