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Medical Review Coordinator/Adm...
SUMMARY OF POSITION:
Review Coordinators are versatile, detail-oriented team members who participate in a variety of functions, including: receiving confidential documents, data entry, preparing files, helping clients with questions, tracking cases through our computerized system, and editing reports to remove typographical and grammatical errors. Coordinators are responsible for ensuring the timeliness of reviews, contacting doctors and clients, and quality assurance activities. Applicants should have basic knowledge of medical terminology, telephone etiquette, and communication skills with refined grammar and writing ability. We do not expect someone to have experience that is an exact match, but we are looking for someone who is willing to learn and grow in the position. We are looking for someone with a positive attitude who is a team player, able to take direction, work in different departments, adjust to changing duties and assignments, work independently, and be a problem solver. As a part-time employee, the applicant will be expected to fill in wherever needed. The applicant must be willing to take responsibility for a wide variety of tasks and contribute to a high quality final product.
The Review Coordinator must:
1. Maintain strict confidentiality of patient-specific information obtained during the case review process and sign a HIPAA Confidentiality Agreement.
2. Complete an orientation program to PRN's Policies and Procedures, as well as URAC's Utilization Management Standards.
3. Maintain a positive attitude regarding the company, its clients, reviewers and co-workers.
4. Monitor case flow from receipt, through Physician assignment, to the completion of a final report and provide ongoing support for the efficient and timely completion of case reviews.
5. Serve as liaison with clients, physicians, nurses and other parties to promote an effective and efficient case review process.
6. Provide input into improvement of the case review process.
7. Negotiate fee arrangements with participating Physician Reviewers and clients when required.
8. Recruit, on an as-needed basis, specialty-matched and state-matched physicians to participate in the review process.
9. Update and expand job-related knowledge and capabilities.
10. Help other departments as needed and other duties as may be assigned.
Unless otherwise required by higher state standards, the Coordinator shall, at a minimum:
1. Have excellent writing and communication skills.
2. Have experience in a healthcare or insurance setting
3. Have basic computer skills
4. Pass a writing skills exam
5. Be team and customer-service oriented
6. Have excellent time management skills
Physicians' Review Network offers a competitive benefits package to our full-time employees. Part-time employees are not eligible.
Physicians' Review Network is an accredited independent medical review organization providing expert, cost effective and unbiased external reviews of healthcare services since 1995. Our clients include all types of healthcare and workers compensation organizations who depend on us for:
Fast Turnaround Times
A Diverse Network of Physician Specialists in all 50 states
Detailed, Quality Controlled Reports Referencing Evidence Based Medicine
To apply, please use the “Apply” button below.
Physicians' Review Network is an equal opportunity employer.