Itemization Review Nurse Supervisor

2 months ago

Dubai, United Arab Emirates ClickJobs.io Full time

JobDescription

JobDescription

The 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 accurateresults
  • Maintain all appeals from all clientsas required
  • Knowledge of and understanding alldepartmental policies and procedures as they relate to ItemizationReview
  • Advance knowledge of Client PaymentPolicy for reviews
  • Knowledge of Quality Controlprocesses as needed
  • Fully understands processof assigning files and assessing nurse’s queuescontinually
  • Fully understands the priority ofall claims daily
  • Maintains monthly matrixreporting
  • Knowledge of CERiS systems and DataBase informatics
  • Maintain teams with minimumassistance from manager
  • Create a team bypromoting a positive workenvironment
  • Additional duties/responsibilitiesas assigned by manager
  • Comply with all safetyrules/regulations, in conjunction with the Injury and IllnessPrevention Program (“IIPP”), as well as,maintain HIPAA compliance

KNOWLEDGE &SKILLS:

  • Advance organizational, strategic andcritical thinking skills
  • Effective andprofessional communication skills
  • Ability tohandle stressful situations and adaptaccordingly
  • Demonstrated outstandingleadership, problem solving, and analyticalskills
  • Ability to think and workindependently
  • Proficient in scheduling monthlyteam meetings with emphasis oneducation
  • Proficient in MedCheck, MedCheckSelect, CareMC, Tableau, UltiPro, Department Employee HandbookPolicy and Procedures, Microsoft Office Suite, Excel, Outlook, andSkype for Business

EDUCATION &EXPERIENCE:

  • Must maintain current licensure as aRegistered Nurse in the state ofemployment
  • Must 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 notmandatory
  • Must have 3 years or HospitalSupervisor/Manager experience
  • Associate Degreein Nursing or higher
  • Experience in medical billauditing, preferred but not mandatory
  • Knowledgeof ICD-10, DRG and coding required but notmandatory

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