Itemization Review Supervisor

About the role

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

Essential Functions & Responsibilities

• Maintain accurate, current data and analytics to support informed decision-making and reliable outcomes
• Manage and track client appeals as required
• Oversee the file assignment process and continuously monitor nurse workloads and queues
• Demonstrate working knowledge of CERIS systems and databases
• Lead and support the team with minimal managerial oversight
• Foster a collaborative and positive work environment through effective team leadership
• Ensure strict adherence to HIPAA compliance standards

Knowledge & Skills

• Comprehensive knowledge of departmental policies and procedures related to Itemization Review
• Advanced understanding of client payment policies as they apply to reviews
• Familiarity with quality control processes
• Strong organizational, strategic thinking, and critical analysis skills
• Excellent written and verbal communication skills
• Ability to manage high-pressure situations and adapt to changing priorities
• Proven leadership, problem-solving, and analytical capabilities
• Ability to work both independently and collaboratively
• Skilled in organizing and facilitating monthly team meetings with a focus on training and development
• Proficiency in MedCheck, MedCheck Select, CareMC, Tableau, UKGPro, departmental policies and procedures, and Microsoft Office Suite (including Excel, Outlook, and Teams)

Education & Experience

• Must maintain current licensure as a Registered Nurse (RN) 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.
• At least 3 years of experience in a hospital supervisor or manager role
• Associate Degree in Nursing or higher
• Minimum of 3 years’ experience in LIBR preferred
• Experience in medical bill auditing preferred
• Knowledge of ICD-10, DRG and coding preferred

Pay

Pay Range: $70,276 – $116,942

Benefits

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.