ExamWorks · 3 hours ago
Quality Assurance Coordinator (31359)
United States
Full-time
Remote
Entry Level
2+ years expExamWorks is a leading provider of innovative healthcare services including independent medical examinations and related services. The Quality Assurance Coordinator is responsible for ensuring reports are completed with the highest quality and integrity, handling quality assurance questions, and providing support to the Quality Assurance Department.
Health CareInsuranceOnline Portals
Responsibilities
Perform quality assurance review of reports, correspondences, addendums or supplemental reviews
Ensure clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations
Ensure that all client instructions and specifications have been followed and that all questions have been addressed
Ensure each review is supported by clinical citations and references when applicable and verifies that all references cited are current and obtained from reputable medical journals and/or publications
Ensure the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards
Ensure that the appropriate board specialty has reviewed the case in compliance with client specifications and/or state mandates and is documented accurately on the case report
Verify that the peer reviewer has attested to only the facts and that no evidence of reviewer conflict of interest exists
Ensure the provider credentials and signature are adhered to the final report
Identify any inconsistencies within the report and contact the Provider to obtain clarification, modification or correction as needed
Assist in resolution of customer complaints and quality assurance issues as needed
Ensure all federal ERISA and/or state mandates are adhered to at all times
Provide insight and direction to management on consultant quality, availability and compliance with all company policies and procedures and client specifications
Promote effective and efficient utilization of company resources
Participate in various educational and or training activities as required
Perform other duties as assigned
Qualification
Required
High school diploma or equivalent required
Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values
Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbers and decimals; Ability to compute rates and percentages
Must be able to operate a general computer, fax, copier, scanner, and telephone
Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet
Must possess excellent skills in English usage, grammar, punctuation and style
Ability to follow instructions and respond to upper managements' directions accurately
Must demonstrate accuracy and thoroughness. Look for ways to improve and promote quality and monitors own work to ensure quality is met
Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed
Must be able to work independently, prioritize work activities and use time efficiently
Must be able to maintain confidentiality
Must be able to demonstrate and promote a positive team -oriented environment
Must be able to stay focused and concentrate under normal or heavy distractions
Must be able to work well under pressure and or stressful conditions and must possess the ability to manage change, delays, or unexpected events appropriately
Ability to follow all company policies and procedures in effect at time of hire and as they may change or be added from time to time
Preferred
Two years IME or medical experience preferred
Knowledge of the insurance industry preferably claims management relative to one or more of the following categories: workers' compensation, no-fault, liability, and/or disability preferred
Must be a qualified typist with a minimum of 40 W.P.M preferred
Benefits
Competitive benefits
Paid time off
401k
Company
ExamWorks
ExamWorks provides medical examinations, peer reviews, bill reviews, Medicare compliance service and IME-related services.
5001-10000 employees
Funding
Current Stage
Public CompanyTotal Funding
unknown2021-06-22Acquired
2010-10-28IPO
Leadership Team
James Price
CEO
Recent News
2023-12-27
Company data provided by crunchbase