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ExamWorks
ExamWorks
5.001 – 10.000 Angajați
Asistență medicalăConsultanțăJuridic

ExamWorks activează la intersecția dintre domeniul medical, consultanță și servicii juridice, oferind examinări medicale independente și evaluări realizate de specialiști de același nivel pentru dosare de despăgubire și procese conexe. Activitatea sa include, de asemenea, verificarea facturilor, conformitatea cu cerințele Medicare, gestionarea dosarelor medicale și a documentelor, precum și audituri de conformitate.

Compania sprijină o rețea extinsă de medici și dezvoltă platforme pentru organizații și instrumente de gestionare a fluxurilor de lucru pentru organizații din domeniul medical. Echipele sale combină expertiza clinică, operațională, de conformitate și tehnologică pentru a ajuta clienții să gestioneze dosarele medicale și cererile de despăgubire cu mai multă consecvență și fiabilitate.

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Locurile de muncă ale companiei

Remote Case Coordinator - California | ExamWorks

Support compliant, high-quality medical review reports for Advanced Medical Reviews. Coordinate peer reviewers, quality checks, client requirements, and regulatory compliance.

USStatele Unite ale AmericiiCACalifornia
19 $ / oră
RemoteNormă întreagăJuniorNivel mediuNu este necesară o diplomăLimbă Obligatorie: englezăCoordonator de cazuriGeneral

Descriere

  • Review reports, correspondence, addenda, and supplemental reviews for quality assurance
  • Confirm that recommendations and determinations are supported by clear, concise, evidence-based rationales
  • Check that client instructions, specifications, and questions are fully addressed
  • Validate that clinical citations and references are current and drawn from reputable medical journals or publications
  • Ensure report content, formatting, and presentation meet company standards
  • Confirm cases receive review by the appropriate board-certified specialty and are documented accurately
  • Verify peer reviewer attestations and conflict-of-interest disclosures
  • Confirm final reports include provider credentials and signatures
  • Investigate report inconsistencies and contact peer reviewers for clarification or correction
  • Support the resolution of customer complaints and quality assurance concerns
  • Maintain compliance with federal ERISA requirements and state mandates
  • Provide management with insight into consultant quality, availability, and compliance
  • Help optimize the use of company resources
  • Take part in educational and training programs
  • Complete other assigned responsibilities

Cerințe

  • High school diploma or equivalent
  • At least two years of clinical or related experience, or an equivalent combination of education and experience
  • Knowledge of insurance operations, preferably claims management involving workers' compensation, no-fault, liability, or disability
  • Strong understanding of medical terminology, anatomy and physiology, medications, and laboratory values
  • Ability to calculate with whole numbers and decimals and determine rates and percentages
  • Typing speed of at least 40 words per minute
  • Ability to use computers, fax machines, copiers, scanners, and telephones
  • Familiarity with Microsoft Word, Outlook, Excel, and the internet
  • Excellent command of English usage, grammar, punctuation, and style
  • Ability to follow instructions accurately and respond appropriately to senior management
  • Ability to work independently, prioritize tasks, and manage time effectively
  • Ability to protect confidential information
  • Ability to remain focused during normal or heavy distractions

Beneficii

  • Medical insurance
  • Vision insurance
  • Dental insurance
  • Paid time off
  • 401(k) plan

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