135 applicants

Company

ExamWorks · 1 day ago

Quality Assurance Coordinator

Rockford, IL

Full-time

Remote

Entry Level

2+ years exp

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Responsibilities

Performs quality assurance review of medical reports, correspondences, addendums or supplemental reviews.

Ensures clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations.

Ensures that all client instructions and specifications have been followed and that all questions have been addressed.

Ensures 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.

Ensures 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.

Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists.

Ensures the provider credentials and signature are adhered to the final report.

Identifies any inconsistencies within the report and contacts the Provider to obtain clarification, modification or correction as needed.

Assists in resolution of customer complaints and quality assurance issues as needed.

Ensures all federal ERISA and/or state mandates are adhered to at all times.

Provides 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

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Medical TerminologyAnatomyPhysiologyGrammarPunctuationMicrosoft WordMicrosoft ExcelMicrosoft OutlookTyping (40 W.P.M)

Required

High school diploma or equivalent required.

Two years of medical office experience.

Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values.

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.

Demonstrates accuracy and thoroughness.

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 stay focused and concentrate under normal or heavy distractions.

Must be able to work well under pressure and or stressful conditions.

Must possess the ability to manage change, delays, or unexpected events appropriately.

Demonstrates reliability and abides by the company attendance policy.