Coordinator-Medical Review

Loma Linda University Health; Loma Linda (CA); On-site; USD 65,000 - 90,000; Full time

Job summary

Loma Linda University Health is seeking a Medical Review Coordinator for the Workers Compensation department. The role focuses on managing the authorization process for referrals and assisting staff with authorization-related issues.

The coordinator will populate forms with patient histories, draft impairment ratings, and help patients with referrals and insurance questions to ensure authorizations for visits and procedures are obtained.

Qualifications

• High School diploma or GED required.
• Three years of workers' compensation experience preferred.
• Experience with medical-legal recording to AOE/COE/QME/AME is a plus.
• Authorization procurement experience preferred.

Responsibilities

• Manage the authorization process for workers' compensation referrals.
• Assist clinical and front office staff with authorization issues.
• Populate Workers’ Compensation forms with history and review of systems.
• Draft impairment ratings for the medical provider’s review.
• Perform additional duties as needed.

Skills

Workers' compensation knowledge

CPT/ICD coding knowledge

Medical terminology

Keyboard speed

Microsoft Office (Word, Outlook)

Attention to detail

Multitasking under pressure

Independent work

Education

High School diploma or GED

Tools

Microsoft Office

Job description

Job Description

Department: UHC: Workers Compensation

Job Summary

The Medical Review Coordinator manages the authorization process for work comp specialty and ancillary referrals. Provide assistance to clinical and front office staff with authorization related issues, assists patients with referral and insurance issues ensuring authorization is obtained for office visits and/or office procedures. Populates the Workers’ Compensation forms with the history of present illness, medical history, and review of systems. Drafts the impairment rating for the medical provider’s review. Performs other duties as needed.

Education and Experience

High School diploma or GED. Three years of workers' compensation experience required. Previous editing and historian experience preferred, especially with medical-legal recording to AOE/COE/QME/AME. Authorization procurement experience preferred.

Knowledge and Skills

Intimate knowledge of workers' compensation guidelines and regulations. Knowledge of CPT and ICD codes preferred. In-depth medical terminology knowledge. Able to keyboard 30 wpm. Able to use a computer, printer, and software programs such as Microsoft Office Word and Outlook. Operate/troubleshoot basic office equipment required for the position. Able to work calmly and respond courteously when under pressure; collaborate and accept direction. Able to think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position.

Licensures and Certifications

None

About Us

Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork and wholeness.

About The Team

Loma Linda University Health is a Seventh-day Adventist, faith and values based Christian institution. Candidates must understand and embrace the mission, purpose, and identity of Loma Linda and its affiliated entities.

We are an equal opportunity employer committed to the principles of diversity. We provide equal opportunities in all aspects of the employment process to every individual, regardless of gender, race, color, age, national origin, ancestry, physical or mental disability, marital or veteran status, genetic information or any other characteristic protected by law. In addition, we will provide reasonable accommodations for otherwise qualified individuals requesting an accommodation due to a disability. If you need accommodation assistance with accessing our job listings or completing an application, or during any other phase of employment with us, please contact Human Resources Management at [phone].

Loma Linda University Health Care is a religiously-qualified Equal Opportunity Employer under Title VII of Civil Rights Act of 1964. No question on this application is asked for the purpose of unlawfully limiting or excluding any applicant’s consideration for employment because of race, color, religion, gender, age, national origin, disability, genetic information, or any other status protected by applicable law. If you need a reasonable accommodation in the hiring process, please notify Human Resource Management.

We appreciate your interest in Loma Linda and wish you success in your job search!