DRG Clinical Registered Nurse Reviewer Manager - ( Must be Certified Professional Coder )
5128 Apache Plume Rd. Suite 400 Fort Worth, TX 76109 US
Job Description
REMOTE
$110 K - $120K DOE
We are hiring a Registered Nurse Clinical Review Manager for a company that provides comprehensive bill review services for the Medical industry. This position is 100% remote and requires an RN license.
The PPI Clinical Review Manager is responsible for the overall aspects of the PPI Clinical Review Department including personnel hiring, quality assurance of product, workflow, maintaining the tracking of and accountability of staff regarding production standards and turn-around expectations.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
- Responsible for managing the daily file flow coming into the PPI Clinical Review while maintaining awareness of potential file flow from other departments to track rush or special files, test files, pilot studies for prospective clients
- Responsible for meeting client specific turnaround times and metrics
- Writing performance evaluations for direct report staff on annual basis
- Keeping Department error ratio to less than 2% on all approved files completed per month
- Responsible for human resources matters directly related to department staff under direct supervision including documentation of events or occurrences and verbal counseling direct report staff when attendance or performance deficiencies are discovered
- Train, Assist and Direct Supervisors as needed
- Requires regular and consistent attendance and the tracking of attendance of staff under direct supervision, in addition to ensuring adequate staffing levels to meet business needs and productivity standards
- Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
- Responsible for implementing new procedures/protocols as necessary
- Responsible for identifying process improvement opportunities and reporting these to the director of audit
- Responsible for maintaining and updating department protocol library
- Responsible for monitoring various reports daily to ensure productivity metrics and client goals are met
- Assist with additional projects as requested
- Participate in provider and client calls as needed
- Participate in leadership calls as needed
- May be required to travel overnight to attend meetings and/or training
- Additional duties as assigned by director of audit and/or SVP of operations
- Proficient in Medicare, CMS guidelines and ICD-10 coding guidelines
- Extreme attention to detail
- Must possess problem solving, critical thinking skills
- Must be team oriented
- Effective and professional communication skills, both verbal and written
- Ability to act in a professional manner with both internal and external customers
- Ability to think and work independently
- Ability to work in a fast-paced production environment
- Proficient in Microsoft Office Suite
- Minimum of 3-5 years of inpatient/DRG coding experience in a group health payment integrity setting or 3 party audit company
- A minimum of 2 years supervisory experience dealing with clinical auditors preferred
- Appropriate certification through AHIMA or AAPC with DRG coding experience in ICD-10, ICD-10 PCS, CPT and HCPCS
- RN and/or compact licensure with DRG coding experience and certifications as above a plus
- Degree in healthcare related field preferred
Medical/Dental
401K
PTO
Employee stock purchase plan
Contact Tez for more details @
972-534-0020 ext.105 or Text 972.525.5539
#CSM
Meet Your Recruiter
Tez Williams
Clinical Recruitment Manager
Tez has been with CornerStone Medical since November 2017. He has spent ten years in the healthcare industry, the last two years as a healthcare recruiter. He developed skills for recruiting, training and managing pipelines of 10-50 clinicians at a time while working for Fortune 500 companies. He also gained experience working multiple verticals within the healthcare industry such as allied health, clinical and non-clinical.
As the Clinical Recruitment Manager, his main objective is to locate talented clinicians who are amazing at what they do and match them with their dream jobs. He serves his candidates to the best of his ability, always going the extra mile to locate the best career opportunities in the marketplace. He once even brought a can of gas to a travel nurse stuck on the side of the road on the FIRST day of her assignment!
Tez graduated from Northwestern State University in Louisiana with a Bachelor of Science.