Manhattan WMOS Engineer
ShyftLabs
Support Manhattan WMOS implementations and operations as a WMS Engineer at ShyftLabs. ShyftLabs builds data products and digital solutions for Fortune 500 companies.
Ochish
ExamWorks sog‘liqni saqlash, konsalting va yuridik xizmatlar kesishgan sohada faoliyat yuritib, da’volar va ular bilan bog‘liq jarayonlar uchun mustaqil tibbiy ko‘riklar hamda ekspert baholashlarini taqdim etadi. Kompaniya faoliyati hisob-fakturalarni ko‘rib chiqish, Medicare talablariga muvofiqlikni ta’minlash, tibbiy yozuvlar va hujjatlarni boshqarish hamda muvofiqlik auditlarini ham qamrab oladi.
Kompaniya shifokorlarning keng tarmog‘ini qo‘llab-quvvatlaydi va sog‘liqni saqlash tashkilotlari uchun korporativ platformalar hamda ish jarayonlarini boshqarish vositalarini ishlab chiqadi. Uning jamoalari klinik, operatsion, muvofiqlik va texnologik tajribani birlashtirib, mijozlarga tibbiy yozuvlar va da’volarni yanada izchil hamda ishonchli boshqarishda yordam beradi.
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.
Tavsif
- 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
Talablar
- 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
Imtiyozlar
- Medical insurance
- Vision insurance
- Dental insurance
- Paid time off
- 401(k) plan
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