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Medical Case Review Coordinator
Santa Monica, California | Contract To Hire
Contract-to Hire opportunity with an amazing company in the Santa Monica area. This national company offers excellent benefits, great location and strong collaborative culture. We are looking for candidates who thrive in positive, team oriented working environments and are passionate about the details! The Case Coordinator is responsible to ensure medical reports are of the highest quality and integrity and in full compliance with client contractual agreement, regulatory agency standards and/or federal and state mandates. This position also assists with quality assurance questions and provides overall support to the Quality Assurance Department.
If you have the skills and qualifications below, please forward your resume for review. We are experts at matching candidates to their dream jobs at Wollborg Michelson Recruiting. If this is your next dream job we are looking forward to speaking with you!
EDUCATION AND/OR EXPERIENCE
- Four-year degree required. A minimum of two years clinical or related field experience; or equivalent combination of education and experience. 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.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Performs quality assurance review of 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 and identifies and corrects any inconsistencies as needed.
- 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.
- Ensures the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards.
- Must have strong working knowledge of medical terminology, anatomy and physiology, medications and laboratory values.
- Must possess strong math and verbal skills.
- Must be comfortable with general office skills and type at a minimum rate of 40 W.P.M.
- Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
- Must be able to maintain confidentiality.
- Must be able to adhere to tight deadlines while maintaining and promoting a positive team-oriented environment.
*Extended hours are occasionally required beyond the regular eight (8) hour work day.*