Hospital Bill Audit Nurse I

We need to output HTML fragment with sections: headings

for sections like About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections that have real specific content. We must not repeat job title. Must not include Job ID etc. Must preserve all substantive info. Remove boilerplate: cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, application instructions. Also remove generic statements like "Additional duties as assigned" maybe keep? It's part of responsibilities. We need to parse the posting. Let's extract content: First paragraph: description of role: "The Hospital Bill Audit Nurse conducts hospital bill charge audits by reviewing medical records to verify that services were provided and charges are appropriate based on medical documentation and industry guidelines. The types of audits performed could include, but are not limited to inpatient, outpatient, NICU, and hospice. Charge audits identify overcharges, undercharges, and unbundled items per payor contract and industry standards. This role is responsible for independent scheduling requiring flexibility and travel to provider location." That's a summary; could be "About the role" section. Then "Essential Functions & Responsibilities" list: bullet points (but they are sentences separated by spaces). We need to convert to

• . List items: - Acknowledge assigned work, maintain timely communication with Audit Coordinator, schedule and complete audits in an efficient and timely manner - Travel onsite as needed to perform audits - Review medical records to verify services were provided and charges are accurate – identify overcharges/undercharges, unbundled items, errors, duplicates, routine services, and equipment/supplies - Identify discrepancies if they exist and document the findings using standard documentation guidelines applicable to the position - Understand audit and data information to make decisions with accurate results - Document all unsupported charges identified during an audit - Report any problems in the auditing process to the manager and/or supervisor for resolution - Comply with all HIPAA and other regulations regarding the confidentiality of patient information - Comply with all provider and internal policies and guidelines - Must represent CorVel/CERIS in a professional and knowledgeable manner - Additional duties as assigned - Onsite scheduling and travel Note: "Onsite scheduling and travel" maybe duplicate of earlier travel. Keep. Then "Knowledge & Skills" list: - Knowledge and understanding of hospital billing/charging including UB-04’s, itemized bills, revenue codes, CPT/HCPCS codes, ICD10 diagnosis and procedure codes - Strong working knowledge of CMS, payor, and other industry guidelines preferred - Excellent written and verbal communication skills necessary to interact positively with both external and internal customers - Computer skills necessary to manage correspondence, information entry and retrieval from system, and the ability to create and participate in virtual meetings - Reasonable proficiency in Microsoft Office applications including Excel - Exceptional attention to detail - Must have advanced organizational, strategic, and critical thinking skills - Ability to handle stressful situations and adapt accordingly - Ability to work in a fast-paced environment - Ability to work independently Then "Education & Experience": - Associate Degree in Nursing or higher required - Must maintain current licensure as a Registered Nurse in the state of employment - Previous external or internal medical bill audit experience highly preferred - Minimum of 5 years’ experience in the OR, ICU, or ER as an RN highly preferred - Hospice experience a plus Then "Pay Range" details: includes paragraph about market based approach, factors, etc. Then "Pay Range: $63,739 – $95,264". Also mention "For leveled roles...". We need to include Pay section only if posting actually states them. It does state pay range. So we include Pay section with that range and maybe note about market based approach? The instruction: "Prefer a few substantive sections over many thin ones." Could combine Pay and Benefits? But Benefits also present: "A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first." Then later: "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." Thus we have benefits details. So we should include Benefits section with that list. Schedule: The posting mentions "independent scheduling requiring flexibility and travel to provider location." Also "Onsite scheduling and travel". Not a specific schedule like shift times. Might not be enough to create a Schedule section (since no concrete schedule). The instruction: never create Pay/Schedule/Benefits sections unless the posting actually states them. For Schedule, we have mention of scheduling flexibility and travel, but not a defined schedule (e.g., full-time, part-time, hours). Might be considered not specific enough. Safer to omit Schedule section. We also have "About CERIS" paragraph describing company. Could be "About the role" or maybe "About the company". The instruction: use headings like About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. So we can put company description under About the role? Or maybe we could add an "About the role" that includes both role description and company info. That's okay. We must not include boilerplate like "CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable." That's EEO boilerplate; remove. Also remove "A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first." That's somewhat boilerplate but also mentions benefit offerings; we already have benefits list. The sentence about posting duration maybe not needed; could be considered boilerplate. Remove. Now construct HTML. We'll have sections:

  About the role

  ... description ...

  Responsibilities

  • ... each ...

  Knowledge & Skills

  • ... each ...

  Education & Experience

  • ... each ...

  Benefits

  • ... each benefit ...

  Pay

  Pay Range: $63,739 – $95,264

  We might also include note about market based approach? Could be part of Pay paragraph. We need to ensure we don't duplicate content. Let's extract responsibilities list precisely. From text: "Essential Functions & Responsibilities Acknowledge assigned work, maintain timely communication with Audit Coordinator, schedule and complete audits in an efficient and timely mannerTravel onsite as needed to perform auditsReview medical records to verify services were provided and charges are accurate – identify overcharges/undercharges, unbundled items, errors, duplicates, routine services, and equipment/suppliesIdentify discrepancies if they exist and document the findings using standard documentation guidelines applicable to the positionUnderstand audit and data information to make decisions with accurate resultsDocument all unsupported charges identified during an audit Report any problems in the auditing process to the manager and/or supervisor for resolutionComply with all HIPAA and other regulations regarding the confidentiality of patient informationComply with all provider and internal policies and guidelines Must represent CorVel/CERIS in a professional and knowledgeable mannerAdditional duties as assignedOnsite scheduling and travel" We need to split into sensible items. Let's create items: - Acknowledge assigned work, maintain timely communication with Audit Coordinator, schedule and complete audits in an efficient and timely manner - Travel onsite as needed to perform audits - Review medical records to verify services were provided and charges are accurate – identify overcharges/undercharges, unbundled items, errors, duplicates, routine services, and equipment/supplies - Identify discrepancies if they exist and document the findings using standard documentation guidelines applicable to the position - Understand audit and data information to make decisions with accurate results - Document all unsupported charges identified during an audit - Report any problems in the auditing process to the manager and/or supervisor for resolution - Comply with all HIPAA and other regulations regarding the confidentiality of patient information - Comply with all provider and internal policies and guidelines - Must represent CorVel/CERIS in a professional and knowledgeable manner - Additional duties as assigned - Onsite scheduling and travel Note "Onsite scheduling and travel" maybe duplicate of travel; but keep. Now Knowledge & Skills list: - Knowledge and understanding of hospital billing/charging including UB-04’s, itemized bills, revenue codes, CPT/HCPCS codes, ICD10 diagnosis and procedure codes - Strong working knowledge of CMS, payor, and other industry guidelines preferred - Excellent written and verbal communication skills necessary to interact positively with both external and internal customers - Computer skills necessary to manage correspondence, information entry and retrieval from system, and the ability to create and participate in virtual meetings - Reasonable proficiency in Microsoft Office applications including Excel - Exceptional attention to detail - Must have advanced organizational, strategic, and critical thinking skills - Ability to handle stressful situations and adapt accordingly - Ability to work in a fast-paced environment - Ability to work independently Education & Experience: - Associate Degree in Nursing or higher required - Must maintain current licensure as a Registered Nurse in the state of employment - Previous external or internal medical bill audit experience highly preferred - Minimum of 5 years’ experience in the OR, ICU, or ER as an RN highly preferred - Hospice experience a plus Benefits list from paragraph: "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." We can split each benefit as list items. Thus: - 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 - Paid time off Pay section: include paragraph about market based approach? The posting includes: "Pay Range CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $63,739 – $95,264" We can include that as a

  under Pay heading. Now About the role: combine initial description and maybe About CERIS paragraph? The About CERIS paragraph: "About