Medical Records / QA Coordinator

Medical Records Quality Assurance Coordinator

Location: Atlanta, GA Pay: $17.00$18.50/hr BOE Sirius Staffing is hiring a Medical Records Quality Assurance Coordinator in Atlanta, GA. This role is responsible for servicing inquiries from clients, physicians, nurses, or representatives acting on behalf of a client. The position includes data preparation, data entry, data tracking, documentation, and filing. All duties are handled with a high degree of quality customer service and in compliance with all regulatory and company standards.

Job Responsibilities

• Perform quality assurance reviews of reports, correspondences, addendums, or supplemental reviews.
• Ensure clear, concise, evidence-based rationales are provided in support of all recommendations and determinations.
• Ensure all client instructions and specifications are followed, and all questions are addressed.
• Verify each review is supported by current clinical citations and references from reputable medical journals or publications when applicable.
• Ensure the content, format, and professional appearance of reports comply with company standards.
• Verify the appropriate board specialty has reviewed the case in compliance with client specifications or state mandates, and document it accurately on the case report.
• Verify the peer reviewer has attested only to the facts and that no evidence of reviewer conflict of interest exists.
• Ensure provider credentials and signatures are adhered to the final report.
• Identify inconsistencies within reports and contact the Provider to obtain clarification, modification, or correction as needed.
• Assist in the resolution of customer complaints and quality assurance issues as needed.
• Ensure all federal ERISA and state mandates are adhered to at all times.
• Provide insight and direction to management on consultant quality, availability, and compliance with company policies, procedures, and client specifications.
• Participate in various educational or training activities as required.
• Read, analyze, and interpret common correspondence, medical records, itemized billing statements, and legal contracts.
• Write clearly and informatively to all audiences, editing work for spelling and grammar, and respond professionally to inquiries from clients, physicians, management, or regulatory agencies.
• Perform other duties as assigned.

Qualifications

• High school diploma or equivalent required.
• Two years of IME or medical experience.
• Strong knowledge of medical terminology, anatomy and physiology, medications, and laboratory values.
• Medical assistance experience is highly preferred.
• Knowledge of the insurance industry; preferably claims management, relative to workers compensation, no-fault, liability, and/or disability preferred.
• Qualified typist with a minimum of 40 WPM preferred.
• Ability to operate a general computer, fax, copier, scanner, telephone, and multiple software programs, including Microsoft Word, Outlook, Excel, and the Internet.
• Ability to add, subtract, multiply, and divide in all units of measure using whole numbers and decimals, and compute rates and percentages.
• Excellent skills in English usage, grammar, punctuation, and style.
• Proven ability to follow instructions, respond to directions accurately, maintain confidentiality, and work independently.
• Strong communication skills to convey information accurately, listen effectively, and question for clarification.
• Ability to stay focused under distractions, work well under pressure, and manage unexpected calendar changes or delays.

Physical Requirements

• Position is generally sedentary, requiring work at a desk or similar office furnishings up to 8 hours a day or longer based on business needs.
• Ability to operate a computer for extended periods throughout a shift
• Ability to move throughout the office and travel to different floors.
• Ability to occasionally lift, carry, push, or pull up to 10 lbs.
• Ability to occasionally bend, squat, or twist.
• Weekend work and extended hours are occasionally required beyond the regular eight-hour workday.
• Work environment noise level is usually moderate.

Sirius Staffing is an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to characteristics such as race, color, national origin, religion, gender, age, marital status, disability, veteran status, citizenship status, sexual orientation, gender identity, or any other status protected by law.