Itemization Review Nurse Supervisor

2 months ago

Dubai, United Arab Emirates ClickJobs.io Full time

Job Description

Job Description

The Itemization Review Supervisor will maintain a positive team building approach with emphasis on reporting, leadership and professional communication with all CERIS departments.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

  • Maintain all data and analytics information to make critical decisions and accurate results
  • Maintain all appeals from all clients as required
  • Knowledge of and understanding all departmental policies and procedures as they relate to Itemization Review
  • Advance knowledge of Client Payment Policy for reviews
  • Knowledge of Quality Control processes as needed
  • Fully understands process of assigning files and assessing nurse’s queues continually
  • Fully understands the priority of all claims daily
  • Maintains monthly matrix reporting
  • Knowledge of CERiS systems and Data Base informatics
  • Maintain teams with minimum assistance from manager
  • Create a team by promoting a positive work environment
  • Additional duties/responsibilities as assigned by manager
  • Comply with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program (“IIPP”), as well as, maintain HIPAA compliance

KNOWLEDGE & SKILLS:

  • Advance 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
  • Proficient in scheduling monthly team meetings with emphasis on education
  • Proficient in MedCheck, MedCheck Select, CareMC, Tableau, UltiPro, Department Employee Handbook Policy and Procedures, Microsoft Office Suite, Excel, Outlook, and Skype for Business

EDUCATION & EXPERIENCE:

  • Must maintain current licensure as a 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.
  • Must have a minimum of 3 years’ experience in LIBR. Preferred but not mandatory
  • Must have 3 years or Hospital Supervisor/Manager experience
  • Associate Degree in Nursing or higher
  • Experience in medical bill auditing, preferred but not mandatory
  • Knowledge of ICD-10, DRG and coding required but not mandatory

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