The Quality Control Nurse is responsible for ensuring and maintaining MCS Bill Review database integrity. Ensures timely application of QC protocols to meet production standards.
This is a remote position.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
- Analyses itemization line item descriptors from hospital billing entered
- Verifies line item data sets for completeness, correctness and understandability
- Maintain the integrity of each provider chargemaster within Scheck
- Maintains consistent communications with the Data Entry Analyst on line item entries
- Maintains constant communications with the Medical Review Department regarding unusual billing practices and discovery of potential errors
- Maintain 100% accuracy of data set(s) PRIOR to moving files to the next department to meet production and turnaround time requirements
- Maintain HIPAA compliance in all aspects of communications
- Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
- Additional tasks as required by Supervisor
KNOWLEDGE & SKILLS:
- Exceptional 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, while working in an overall team environment
- Proficient in MedCheck Select V5.0, Microsoft Office Suite, Excel, Outlook, and Skype for Business
EDUCATION/EXPERIENCE:
- Must maintain current licensure as a Licensed Practical Nurse or 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. or 10+ years of patient care in a medical setting
- Current license or Associate Degree in Nursing or higher
- Experience in medical bill auditing, preferred but not mandatory
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: $52,999 – $85,473
A list of our benefit offerings can be found on our CorVel website: