Job Description
Description Are You a Medical Assistant Ready to Break Free from the Office and Go Remote? If you're a
Medical Assistant looking to make a career shift from the traditional office setting to a
remote role , we've got an exciting opportunity just for you!
ExamWorks is seeking a
Quality Assurance Coordinator with
prior authorization experience to join our team. In this role, you’ll ensure medical reports are
spot-on by reviewing for errors in
grammar ,
medical terminology , and
content accuracy . Your sharp attention to detail will be crucial in maintaining the highest standards of quality.
Why You’ll Love This Job - 100% remote—work from home where you're most comfortable!
- Tuesday through Saturday schedule: Tuesday through Friday 8:30am-5:00pm CT and Saturday 7:30am-4:00pm CT.
- Employee-first culture with great benefits —because we believe in investing in YOU!
Duties And Responsibilities - Performs quality assurance review of medical reports, correspondences, addendums or supplemental reviews.
- Ensures clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations.
- Ensures that all client instructions and specifications have been followed and that all questions have been addressed.
- Ensures each review is supported by clinical citations and references when applicable and verifies that all references cited are current and obtained from reputable medical journals and/or publications.
- Ensures the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards.
- Ensure that the appropriate board specialty has reviewed the case in compliance with client specifications and/or state mandates and is documented accurately on the case report.
- Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists.
- Ensures the provider credentials and signature are adhered to the final report.
- Identifies any inconsistencies within the report and contacts the Provider to obtain clarification, modification or correction as needed.
- Assists in resolution of customer complaints and quality assurance issues as needed.
- Ensures all federal ERISA and/or state mandates are adhered to at all times.
- Provides insight and direction to management on consultant quality, availability and compliance with all company policies and procedures and client specifications.
- Promote effective and efficient utilization of company resources.
- Participate in various educational and or training activities as required.
- Perform other duties as assigned.
If you're ready for a new challenge and want to thrive in a role that offers work-life balance, apply now and start your journey with
ExamWorks today!
Qualifications - High school diploma or equivalent required.
- Two years of medical office experience.
- Experience working with prior authorizations preferred.
- Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values.
- Qualified typist with a minimum of 40 W.P.M preferred
- Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
- Must possess excellent skills in English usage, grammar, punctuation and style.
- Ability to follow instructions and respond to upper managements’ directions accurately.
- Demonstrates accuracy and thoroughness.
- 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 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.
- Demonstrates reliability and abides by the company attendance policy.
ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages.
Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.
ExamWorks offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.
Equal Opportunity Employer - Minorities/Females/Disabled/Veterans
Job Tags
Work at office, Local area, Remote work, Shift work, Saturday,