[Hiring] Quality Control Nurse I @CorVel Career Site

Role Description

The Quality Control Nurse is responsible for ensuring and maintaining MCS Bill Review database integrity. Ensures timely application of QC protocols to meet production standards. This is a remote position.

Essential Functions & Responsibilities:

• Analyses itemization line item descriptors from hospital billing entered
• Verifies line item data sets for completeness, correctness and understandability
• Maintain the integrity of each provider chargemaster within Scheck
• Maintains consistent communications with the Data Entry Analyst on line item entries
• Maintains constant communications with the Medical Review Department regarding unusual billing practices and discovery of potential errors
• Maintain 100% accuracy of data set(s) PRIOR to moving files to the next department to meet production and turnaround time requirements
• Maintain HIPAA compliance in all aspects of communications
• Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
• Additional tasks as required by Supervisor

Qualifications

• Exceptional organizational, strategic and critical thinking skills
• Effective and professional communication skills
• Ability to handle stressful situations and adapt accordingly
• Demonstrated outstanding leadership, problem solving, and analytical skills
• Ability to think and work independently, while working in an overall team environment
• Proficient in MedCheck Select V5.0, Microsoft Office Suite, Excel, Outlook, and Skype for Business

Requirements

• Must maintain current licensure as a Licensed Practical Nurse or Registered Nurse 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. or 10+ years of patient care in a medical setting
• Current license or Associate Degree in Nursing or higher
• Experience in medical bill auditing, preferred but not mandatory

Benefits

• Comprehensive benefits package 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!).