Itemization Review Nurse II
CorVel · Centralia, WA
Job description
Itemization Review Nurse II The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position. Essential functions and responsibilities include: • Collects supporting data and analyzes information to make decisions regarding accuracy of billing • Appropriately documents work and final conclusions in designated computer program • Understanding of Surgical Implants • Meets department's expectations and standards • Additional duties as assigned Knowledge and skills required include: • Understanding of Itemization Review for designated clients • Understanding of CERIS systems and Data Base informatics • Understanding of HIPAA regulations • Exceptional organizational skills with the ability to handle stressful situations and adapt accordingly • Demonstrated leadership skills; ability to work with Leadership Team(s) within a positive team environment • Strategic problem solving, analytical, and critical thinking skills • Effective written and verbal communication skills • Ability to work independently and within a team environment • Proficiency with Microsoft Office Suite, including Excel, Outlook, Teams Education and experience required include: • 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. • Associate Degree in Nursing or higher • Experience in medical bill auditing preferred but not mandatory Pay range: $61,053 – $98,334 A comprehensive benefits package is available for full-time regular employees and includes 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, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
More jobs in Centralia, WA
$85k–$110k/yr
$85 - $110K /Yr! Hiring CDL-A Truck Drivers - Quick Apply!
Hiring Drivers Now · Centralia, WA
Now Hiring CDL-A Truck Drivers! Apply today and within 24 hours you'll receive multiple job offers. Earn $.60 - $.80+ CPM and up per year based on position. Simply select the driving job that offers you what is most important. Higher pay, increased benefits or more home-time: You choose. Avg. Company Driver Job Offers Salary: $85,000-$110,000+ Avg. Owner Operator Job Offers Salary: $200,000-$325,000+ Apply now to receive your job offers!
CDL-A Owner Operator Truck Driver Job (Earn $5,500 - $9,000/Wk)
Hiring Drivers Now · Centralia, WA
Class A Owner Operator Truck Driver Job (Earn $5,500 - $9,000/Wk) Apply today and within 24 hours you'll receive multiple job offers. Earn $5,500 - $9,000/Wkr based on position/location. Simply select the driving job that offers you what is most important. Higher pay, increased benefits or more home-time: You choose. Owner Operator Driver Pay: $5,500 - $9,000/Wk Apply now to receive your job offers!
No Experience Needed - Remote Customer Service Rep
AO Globe Life · Centralia, WA
Empower Members. Protect Legacies. About Us AO Globe Life has a 70-year legacy of delivering exceptional service and trusted insurance solutions to veterans, labor union members, credit union members, and their families. We pride ourselves on offering expert guidance and support, ensuring our members secure the life insurance and supplemental benefits they need to protect their loved ones and build lasting legacies. We are seeking driven and service-oriented professionals to join our team as Remote Insurance Specialists. This role provides a unique opportunity to make a meaningful impact while benefiting from the flexibility and earning potential of a remote work environment. What We Offer • Fully Remote Position - Enjoy the freedom to work from anywhere. • Six-Figure Earning Potential - Competitive, uncapped commissions. • Exclusive Warm Leads - No cold calling; leads are provided from our extensive membership database. • No Overhead Costs - Focus on what matters most-our members. • Top Performance Incentives - Recognition and rewards for outstanding results. • Union Membership - OPEIU Local 277. • Established Stability - Be part of a 70-year-old organization with a strong commitment to member satisfaction and legendary service. Key Responsibilities • Engage with members through daily calls, leveraging our warm lead database. • Assess financial needs and recommend tailored insurance and supplemental benefits solutions. • Deliver exceptional customer service to ensure member satisfaction and retention. • Guide members through the application process, addressing questions and concerns promptly. • Provide ongoing policy support, including policy reviews, beneficiary updates, and claims assistance. • Maintain compliance with all regulatory and ethical standards in life insurance sales and servicing. Ideal Candidate Profile • Strong communication skills, both written and verbal. • Proficient in organization, time management, and computer-based tools. • Self-motivated, detail-oriented, and driven to exceed sales goals. • Demonstrated sales experience (preferred). • Ability to qualify for a Life Insurance License. • Competitive mindset with excellent problem-solving and critical-thinking skills. • Comfortable working independently and collaboratively in a remote team environment. • Open to feedback, coachable, and eager to implement constructive advice. Eligibility Requirements • Must be a U.S. citizen or legally authorized to work in the United States. • We are currently unable to hire non-U.S. residents. This role offers an exceptional opportunity to combine your passion for helping others with a lucrative, rewarding career. If you're ready to take your skills to the next level and make a lasting difference in the lives of others, we encourage you to apply today.
RN Tele-Health Triage Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. The RN Tele-Health Triage is a registered nurse who is responsible for incoming calls and transferred calls from patients, physicians, and healthcare organizations. Using nursing knowledge and departmental protocols, the Primary Care at Home Desk RN will assess the patient and will follow triage guidelines and protocols to offer appropriate options for care. The RN will escalate concerns/high acuity cases according to guidelines to Primary Care at Home providers and medical director. The Primary Care at Home Desk RN will document appropriately in EPIC to ensure accurate departmental record keeping. The Primary Care at Home Desk RN will facilitate referrals to primary care providers, specialists, healthcare facilities, community resources, and facilities. Supports benefit verification and prior authorizations for health care services/procedures that require authorization per payor/plan requirements. Collects pertinent information needed for medical review from referring provider to ensure service decisions are determined within appropriate timeframes. The Primary Care at Home Desk RN will own and modify triage and authorization workflows and will educate staff about triage and authorization processes. The Primary Care at Home Desk RN will be flexible and adapt to changes in policy and procedures, new techniques, and additional responsibilities as assigned to meet changing business needs. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • Associates of Science in Nursing • RN from an approved school of nursing with current license to practice professional nursing in the State of Texas • 5+ years of total progressive clinical RN experience for adult and/or pediatric patients • 2+ years of experience with capitated payment arrangements • 1+ years of experience specifically working with insurance (HMO, PPO, and POS) companies to obtain authorizations and precertification for medical services • Experience with EMRs and medical records • Familiarity and application of CPT, ICD, and HCPS codes • Basic PC skills including Windows Operating System • Typing skills of 30 WPM • Proven excellent communication skills • Proven ability to multi-task and prioritize responsibilities • Ability to travel throughout the greater Houston area to facilities and patient homes. Must have reliable transportation and current insurance coverage Preferred Qualifications: • Bachelor of Science in Nursing • Certified Coder • 2+ years in ambulatory/primary care setting. • Experience with EPIC EMR *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $29 - $52 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.