Clerical Quality Assurance Coordinator (31431)

SUMMARY

The Clerical Quality Assurance Coordinator is responsible for handling various tasks related to client reports including, but not limited to: receiving, coordinating, assigning and returning completed reports to clients. This position works closely with the clinical quality assurance team and ensures work is processed and completed of the highest quality and in compliance with all policy and procedures.

ESSENTIAL JOB FUNCTIONS

• Receive client submissions and input client and examinee data in the system.
• Verify all cases contain information needed for the clinical review process.
• Maintain daily contact with the Clinical QA Department regarding workflow and status of pending reports.
• Track documentation of all processes, communications, report status and due dates.
•  Maintain a daily log of files that require follow up, clarification or concerns in the tracker.
• Receive completed reports and review for completeness and accuracy, including proper formatting, grammar and sentence structure.
• Complete and or ensures all invoicing is billed daily and in accordance with company practices and client contract agreements.
• Handle and respond promptly to incoming communication from physicians or clients requesting report status or information.
• Work with transcriptionists and/or physicians’ offices regarding report details, clarification, addendums, etc.
• Ensure all medical records and reports are properly documented and saved in the appropriate location.
• Notify management of any report issues or concerns.
• Ensure all practices are carried out in accordance with HIPAA compliance practices, state and federal safety standards and legal regulations
• Promote effective and efficient utilization of clinical resources and supplies.
• Perform other duties as assigned.

MINIMUM REQUIRED QUALIFICATIONS

Education and/or Experience  

High school diploma or equivalent required. Minimum one year clerical experience; or equivalent combination of education and experience preferred. Experience in a medical office or insurance industry preferred.

Certificates, Licenses, Registrations  

No specific requirements.

ESSENTIAL COMPETENCIES

QUALIFICATIONS 

• Must possess knowledge of 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 have a full understanding of HIPAA regulations and compliance.

• Must be a qualified typist with a minimum of 40 W.P.M.
• Ability to follow instructions and respond to managements’ directions accurately.
• Must demonstrate accuracy, thoroughness, and responsibility for quality of work, and ability to take initiative to identify improvements. Looks 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.
• 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.

LANGUAGE/COMMUNICATION SKILLS

• Ability to read, analyze and interpret common correspondence, medical records, and legal contracts and documents.
• Ability to write clearly and informatively to all required audiences and edit own work for appropriate spelling and grammar.
• Ability to respond appropriately and professionally to all inquiries or complaints from customers, physicians, regulatory agencies, and/or members of the business community. 
• Ability to effectively present information one-on-one or in small groups.

As a division of AllMed Healthcare Management, LLC., a nationally recognized, URAC accredited Independent Review Organization (IRO), and URAC and NCQA accredited Utilization Management program, ExamWorks UM Strategies delivers scalable, people-centered utilization management strategies that empower health plans and payers alike. We combine expert clinical insight with a deep understanding of the managed care space to streamline prior authorizations, utilization reviews, and complex clinical decisions.

ExamWorks UM Strategies offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.

Equal Opportunity Employer - Minorities/Females/Disabled/Veterans

Salary : $20 - $22