Clerical Quality Assurance Coordinator

🔥 0 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $18 / hour

⏰ Full Time

🟢 Junior

🔧 QA Engineer (Quality Assurance)

🚫👨‍🎓 No degree required

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Advanced Medical Reviews

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2004

🏥 Healthcare

💼 Consulting

⚖️ Legal

Healthcare • Consulting • Legal

Advanced Medical Reviews is an independent medical review organization (IRO) that provides evidence-based, unbiased independent medical review and utilization management services to healthcare payers and organizations. Since 2004, AMR has offered URAC- and NCQA-aligned review services, leveraging a network of physician reviewers to support appeals, compliance, and quality assurance efforts. The company focuses on ensuring patients receive appropriate care through standardized, expert clinical review.

📋 Description

• 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 ensures 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.

🎯 Requirements

• High school diploma or equivalent required. • Minimum one year clerical experience; or equivalent combination of education and experience preferred. • Experience in a medical office or insurance industry preferred. • Must possess complete knowledge of general computer, fax, copier, scanner, and telephone. • Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet. • Must have a full understanding of HIPAA regulations and compliance. • Must be a qualified typist with a minimum of 40 W.P.M. • Ability to follow instructions and respond to managements’ directions accurately. • Demonstrates accuracy and thoroughness. • Looks for ways to improve and promote quality and monitors own work to ensure quality is met. • 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 demonstrate and promote a positive team -oriented environment. • 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. • Must maintain a professional and clean appearance at all times consistent with company standards.