[Hiring] 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!).