Quality Assurance Coordinator (32273)

SUMMARY

Clerical Quality Assurance Coordinator is responsible for handling various tasks related to client reports including 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 ensure 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

High school diploma or equivalent required. Two years medical experience preferred. Knowledge of the insurance industry preferably claims management relative to one or more of the following categories: workers' compensation, no-fault, liability, and/or disability.

ESSENTIAL COMPETENCIES

QUALIFICATIONS

Strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values. Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers and decimals; compute rates and percentages. Qualified typist with a minimum of 40 W.P.M. Able to operate general computer, fax, copier, scanner, and telephone. Knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet. Excellent skills in English usage, grammar, punctuation and style. Ability to follow instructions and respond to upper management’s directions accurately. Demonstrate accuracy and thoroughness, continuously improving and promoting quality. Exceptional communication skills: convey necessary information accurately, listen effectively and ask clarifying questions. Work independently, prioritize and use time efficiently. Maintain confidentiality. Promote a positive team‑oriented environment. Stay focused under normal or heavy distractions. Work well under pressure and manage change, delays or unexpected events appropriately. Follow all company policies and procedures in effect at time of hire and as they may change.

LANGUAGE /COMMUNICATION SKILLS

Read, analyze and interpret common correspondence, medical records, itemized billing statements and legal contracts. Write clearly and informatively for all audiences; edit own work for appropriate spelling and grammar. Respond appropriately and professionally to inquiries or complaints from clients, physicians, upper management, regulatory agencies, and business community members. Effectively present information one‑on‑one, in small groups, and/or to clients or vendors.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Ability to work at a desk or similar office furnishings up to 8 hours a day or longer as required by business needs. Ability to operate a computer up to 4 hours at a time. Ability to travel to different floors of the office or other locations. Ability to move throughout the office. Occasionally lifting and/or carrying up to 10 lbs. Occasionally pushing/pulling up to 10 lbs. Occasionally subject to bending, squatting, or twisting.

BENEFITS

Competitive benefits (medical, vision, dental), paid time off, and 401k available to employees. Equal Opportunity Employer - Minorities/Females/Disabled/Veterans #J-18808-Ljbffr AllMed Medical Management