Itemization Review Nurse Supervisor

3 weeks ago


dubai, United Arab Emirates ClickJobs.io Full time
Job DescriptionJob DescriptionThe 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 resultsMaintain all appeals from all clients as requiredKnowledge of and understanding all departmental policies and procedures as they relate to Itemization ReviewAdvance knowledge of Client Payment Policy for reviewsKnowledge of Quality Control processes as neededFully understands process of assigning files and assessing nurse’s queues continuallyFully understands the priority of all claims dailyMaintains monthly matrix reportingKnowledge of CERiS systems and Data Base informaticsMaintain teams with minimum assistance from managerCreate a team by promoting a positive work environmentAdditional duties/responsibilities as assigned by managerComply with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program (“IIPP”), as well as, maintain HIPAA complianceKNOWLEDGE & SKILLS:Advance organizational, strategic and critical thinking skillsEffective and professional communication skillsAbility to handle stressful situations and adapt accordinglyDemonstrated outstanding leadership, problem solving, and analytical skillsAbility to think and work independentlyProficient in scheduling monthly team meetings with emphasis on educationProficient in MedCheck, MedCheck Select, CareMC, Tableau, UltiPro, Department Employee Handbook Policy and Procedures, Microsoft Office Suite, Excel, Outlook, and Skype for BusinessEDUCATION & EXPERIENCE:Must 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.Must have a minimum of 3 years’ experience in LIBR. Preferred but not mandatoryMust have 3 years or Hospital Supervisor/Manager experienceAssociate Degree in Nursing or higherExperience in medical bill auditing, preferred but not mandatoryKnowledge of ICD-10, DRG and coding required but not mandatory Disclaimer: Drjobs.ae
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