What are the responsibilities and job description for the Healthcare Review Specialist position at Managed Medical Review Organization?
Healthcare Review Specialist
Full-Time · Requires on-call (remote) coverage that includes evenings, holidays and weekends on a rotating schedule
MMRO is seeking a detail-oriented and professional Healthcare Review Specialist to support the lifecycle of independent medical review cases. This role serves as the critical liaison between referring parties, Physicians and Nurses, ensuring each case is accurately received, assessed, set up, and documented.
This position includes rotating on-call weekend availability (typically 2–3 hours) and occasional evening or holiday coverage.
Key Responsibilities
- Receive and triage incoming medical review requests
- Review requests for case type, completeness, and conflict of interest
- Set up medical files and document cases in internal systems/portal
- Serve as primary liaison between clients, Physicians & Nurses
- Ensure all information is handled in alignment with confidentiality protocols
- Participate in rotating on-call coverage as scheduled
Required Qualifications
- High School Diploma or GED
- Minimum 2 years of relevant professional experience
- Excellent verbal & written communication skills
- Strong customer service skills and professional phone presence
- Proficiency in Microsoft Office (Word, Outlook, data entry)
- Working knowledge of medical terminology
Preferred Qualifications
- Prior experience in independent medical review or URAC-related operations
- 1 year experience in telephonic medical/clinical support
- Advanced data entry and documentation accuracy
- Experience handling confidential information and sensitive timelines
- Ability to prioritize, work independently, and perform well under pressure
Why Join MMRO?
- Mission-driven organization with strong operational integrity
- Professional, collaborative work environment
- PTO compensation for on-call hours bonus PTO
- Opportunity to grow within the medical review/clinical operations space
A Cover Letter is Required to be considered for this role.