Case Coordinator

AllMed Healthcare Management; United States; Remote; USD 40,000 - 70,000; Full time

Job summary

A forward-thinking company is seeking a detail-oriented Case Coordinator to join their fully remote team. This full-time role offers flexible hours and focuses on ensuring the highest quality of reports while adhering to client and regulatory standards. The ideal candidate will possess strong verbal communication skills, a solid understanding of medical terminology, and a knack for quality assurance. In this dynamic position, you will play a crucial role in enhancing patient care and supporting healthcare organizations with your expertise. Join a fast-paced environment that values professionalism and offers competitive benefits.

Benefits

Paid Time Off

401k Plan

Competitive Benefits

Qualifications

• High school diploma or equivalent; clinical or related field experience preferred.
• Knowledge of medical terminology, anatomy, and physiology is essential.

Responsibilities

• Perform quality assurance reviews of reports and ensure compliance with standards.
• Support reports with credible medical citations and maintain professional appearance.

Skills

Verbal Communication

Attention to Detail

Medical Terminology Knowledge

Computer Proficiency

Typing Speed (40 WPM)

Education

High School Diploma

Tools

Microsoft Office

Job description

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?

Then 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, in full compliance with client contractual agreements, regulatory standards, and federal and state mandates. This position also involves assisting with quality assurance questions and supporting the Quality Assurance Department.

Responsibilities

1. Perform quality assurance reviews of reports, correspondences, addendums, or supplemental reviews.
2. Ensure clear, concise, evidence-based rationales support all recommendations and determinations.
3. Follow all client instructions and specifications, and address all questions.
4. Support reports with current, reputable medical citations and references, verifying their credibility.
5. Maintain the highest quality and professional appearance of reports, complying with company standards.
6. Ensure appropriate review by the relevant board specialty, in accordance with client and state requirements, and accurate documentation.
7. Verify peer reviewer attestations, ensuring no conflicts of interest.
8. Ensure provider credentials and signatures are correctly included.
9. Identify inconsistencies within reports and coordinate with peer reviewers for clarification or corrections.
10. Assist in resolving customer complaints and quality issues.
11. Adhere to all federal ERISA and state mandates.
12. Provide insights and guidance on quality, availability, and compliance issues to management.
13. Promote efficient use of company resources.
14. Participate in training and educational activities.
15. Perform other duties as assigned.

Qualifications

• High school diploma or equivalent; clinical or related field experience preferred.
• Knowledge of medical terminology, anatomy, physiology, medications, and lab values.
• Proficiency in basic math and ability to compute rates and percentages.
• Qualified typist with at least 40 WPM.
• Proficient in computer operations and software including Microsoft Office and internet tools.
• Excellent command of English language, grammar, punctuation, and style.
• Ability to follow instructions, work independently, and prioritize tasks.
• Maintain confidentiality and demonstrate professionalism.
• Strong communication skills and ability to work under pressure.
• Reliable and punctual, with a professional appearance.

About Us

AllMed provides clinical decision-making and utilization management solutions to healthcare organizations. We aim to deliver high-quality care, enhance patient experience, and ensure appropriate utilization of health services. Our team of experts designs solutions that integrate seamlessly into your organization to support timely, appropriate care.

We offer a fast-paced team environment with competitive benefits, paid time off, and a 401k plan.

Equal Opportunity Employer

Minorities/Females/Disabled/Veterans