Medical Report Editor

hace 2 semanas

Santa Fe Springs, California, Argentina Los Angeles Orthopedic Surgery Specialists A tiempo completo

Have you worked with California Workers' Comp, Bodily Injury, and/or Disability Claims? Brimming with expertise in the medical, insurance and/or legal background and eager to apply it somewhere?

Our Medical Records Report Editor & Proofreader reviews the internal medical reports and ensure they are completed at the highest level of quality and integrity. Not only ensuring they are in full compliance, but also handles the inquiries and provides strong support to the department.

This is a remote position, but requires experience with California Worker's Compensation.

Responsibilities:

  • Performs quality assurance review of medical reports, correspondences, addendum's or supplemental reviews.
  • Review reports for grammar, medical terminology and content accuracy.
  • 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.
  • Identifies any inconsistencies within the report and contacts the Provider to obtain clarification, modification or correction as needed.

REQUIREMENTS:

  • High school diploma or equivalent required.
  • Clinical background is preferred.
  • 2 years of experience with QME, Initials, P&S, IME and/or insurance industry preferably claims management relative to one or more of the following categories: workers' compensation, no-fault, liability, and/or disability.
  • Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values.

QUALIFICATIONS:

  • 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.
  • Demonstrates accuracy and thoroughness.
  • Must be able to work independently, prioritize work activities and use time efficiently.
  • Must possess the ability to manage change, delays, or unexpected events appropriately.

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