Clerical Quality Assurance Coordinator - Case Prepper (32941)

AllMed Medical Management; Portland (OR); On-site; USD 42,000 - 56,000; Full time

Job summary

AllMed Medical Management is seeking a detail oriented Clerical Quality Assurance Coordinator- Case Prepper to join our team in Portland, OR. You will receive client submissions, input data, and ensure completeness of reports for clinical review.

The role requires strong data entry, document management, and invoicing accuracy, with emphasis on HIPAA and regulatory compliance while you collaborate with the clinical QA team.

Qualifications

• High school diploma or equivalent required.
• A minimum of two years clinical or related field experience, or equivalent combination of education and experience.
• Knowledge of the insurance industry preferably claims management relative to workers compensation, no-fault, liability, and/or disability.

Responsibilities

• 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.

Skills

Typing 40 WPM

MS Office proficiency

Attention to detail

HIPAA compliance

English communication

Education

High school diploma

2+ years clinical or related field experience

Tools

MS Office (Outlook, Word, Excel)

Google Chrome

PDF/XLSX/TIFF/JPG/DOCX filetypes

Job description

Description

AllMed is looking for a detail oriented Clerical Quality Assurance Coordinator- Case Prepper to join our team!

The Clerical Quality Assurance Coordinator - Case Prepper is responsible for handling various tasks related to client reports including, but not limited to: receiving, coordinating, assigning and returning completed reports to clients. This position works closely with the clinical quality assurance team and ensures work is processed and completed of the highest quality and in compliance with all policy and procedures.

RESPONSIBILITIES

• 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.

Qualifications

EDUCATION AND/OR EXPERIENCE

• High school diploma or equivalent required.
• A minimum of two years clinical or related field experience, or equivalent combination of education and experience.
• Knowledge of the insurance industry preferably claims management relative to one of more of the following categories: workers compensation, no-fault, liability, and/or disability.

QUALIFICATIONS

• Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values.
• Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbers and decimals; Ability to compute rates and percentages.
• Comprehensive understanding of filetypes like PDF, XLSX, TIFF, JPG, DOCX
• Must be a qualified typist with a minimum of 40 W.P.M
• Proficiency with PC programs, specifically MS Office (Outlook, Word, Excel), Google Chrome
• High proficiency with Windows or Mac OS.
• Must possess excellent skills in English usage, grammar, punctuation and style.
• Ability to accurately follow instructions and respond to directions from upper management.
• 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.

About Us:

AllMed provides clinical decision making and utilization management solutions to leading payer and provider organizations. We work closely with your team toward a shared vision of healthcare that delivers the highest quality, values patient experience, and ensures both appropriate care and utilization of health-related services.

Our solutions are developed and delivered by experts-they are thoughtfully designed to integrate seamlessly into your organization and help you deliver the right care to the right patients at the right time.

AllMed offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.

Equal Opportunity Employer - Minorities/Females/Disabled/Veterans