Case Coordinator

Allmedmd; Portland (OR); Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a meticulous Case Coordinator to join their dynamic team. This fully remote role requires a sharp eye for detail and strong verbal communication skills. You'll be responsible for ensuring the highest quality reports that comply with regulatory standards and client agreements. With a flexible Tuesday-Saturday schedule, this position offers the chance to make a significant impact in healthcare decision-making while enjoying competitive benefits and a supportive team environment. If you're ready to contribute to high-quality healthcare solutions, this opportunity is perfect for you.

Benefits

Competitive Benefits

Paid Time Off

401k Plan

Qualifications

• Minimum two years of clinical or related experience required.
• Strong knowledge of medical terminology and anatomy essential.

Responsibilities

• Perform quality assurance reviews of reports and correspondences.
• Ensure compliance with client instructions and federal mandates.

Skills

Verbal Communication

Attention to Detail

Medical Terminology

Basic Math Calculations

Typing Speed (40 WPM)

Education

High School Diploma or Equivalent

2+ Years Clinical Experience

Tools

Microsoft Office

Job description

Job Details

Job Location: Portland, OR

Position Type: Full Time

Salary Range: $16.00 - $18.00 Hourly

Travel Percentage: None

Description

Have a sharp eye and keen attention to detail? Do you have editing and/or proof-reading experience? Are you someone who has strong verbal communication skills?

Consider our fully remote Case Coordinator role. This is a full-time Tuesday-Saturday work schedule. Hours are flexible based on your time zone, ideally 8:30am-5pm PST or 10am-6:30pm EST.

The Case Coordinator is responsible for ensuring reports are of the highest quality and integrity, fully compliant with client contractual agreements, regulatory standards, and federal and state mandates. This role supports the Quality Assurance Department with quality assurance questions and overall support.

• Performs quality assurance reviews of reports, correspondences, addendums, or supplemental reviews.
• Ensures clear, concise, evidence-based rationales support all recommendations and determinations.
• Follows all client instructions and specifications, addressing all questions.
• Supports reports with current, reputable medical citations and references.
• Maintains professional appearance and format of reports, ensuring high quality and compliance with standards.
• Ensures reviews are conducted by appropriate board specialists, documented accurately, and free of conflicts of interest.
• Verifies provider credentials and signatures are correctly applied.
• Identifies inconsistencies and contacts reviewers for clarification or correction.
• Assists in resolving customer complaints and quality issues.
• Adheres to all federal ERISA and state mandates.
• Provides insights and guidance on quality, availability, and compliance issues to management.
• Promotes efficient resource utilization.
• Participates in training and educational activities.
• Performs other duties as assigned.

Qualifications

Education and Experience: High school diploma or equivalent required; minimum two years of clinical or related experience, or an equivalent combination. Knowledge of insurance claims management, especially in workers' compensation, no-fault, liability, or disability.

Qualifications: Must have strong knowledge of medical terminology, anatomy, physiology, medications, and lab values. Ability to perform basic math calculations, type at 40 WPM, operate standard office equipment, and proficiency in Microsoft Office and internet use. Excellent English language skills, accuracy, thoroughness, and the ability to follow instructions are essential. Strong communication skills, independence, confidentiality, reliability, professionalism, and the ability to work under pressure are required. Ability to adapt to change and promote a positive team environment is also necessary.

About Us: AllMed provides clinical decision-making and utilization management solutions to leading healthcare organizations. We aim to deliver high-quality healthcare, prioritize patient experience, and ensure appropriate utilization of health services. We offer a dynamic team environment with competitive benefits, paid time off, and a 401k. We are an Equal Opportunity Employer - Minorities/Females/Disabled/Veterans.