Disability Review Specialist

Managed Medical Review Organization; Novi (MI); On-site; USD 55,000 - 75,000; Full time

Job summary

Managed Medical Review Organization is seeking a detail-oriented Disability Review Specialist (DRS) to manage the full lifecycle of disability review service requests. This role requires excellent communication, strong grammar, and the ability to juggle multiple deadlines in a team-based setting.

You will coordinate between referring parties, Physician Reviewers, and the Quality Nurse Reviewer to ensure accurate, compliant, and timely reports, while maintaining documentation and confidentiality

Qualifications

• High School Diploma or GED.
• Minimum 2 years of related professional experience.
• Excellent written and verbal communication skills.
• Strong grammar and professional communication style.
• Strong customer service skills.
• Working knowledge of Microsoft Office and database systems.
• Knowledge of medical terminology.
• Experience handling confidential and sensitive information.
• Ability to work under pressure and manage multiple competing deadlines.

Responsibilities

• Receive and process initial disability review service requests from referring parties.
• Review cases to determine correct service type and verify required documentation.
• Identify and document conflicts of interest in accordance with corporate policy.
• Confirm appropriateness and clarity of clinical review questions.
• Select appropriate Physician Reviewer(s) based on availability, specialty, client pricing.
• Maintain ongoing communication with Physician Reviewers to ensure timely report completion.
• Create appropriate DR report templates for Physician Reviewer completion.
• Coordinate scheduling and service timelines.
• Communicate status updates and delays to referring parties.
• Finalize reports following QNR approval.
• Deliver completed reports to referring parties.
• Accurately document all case activities.
• Enter Physician Reviewer costs and client charges for invoicing approval.
• Protect confidential patient information in compliance with corporate confidentiality policies.
• Seek clinical direction when appropriate.
• Perform other duties as assigned.

Skills

Attention to detail

Strong grammar

Communication

Customer service

Organizational skills

Confidential data handling

Education

High School Diploma or GED

Tools

Microsoft Office

Database systems

Job description

We are seeking a detail-oriented, professional, and highly reliable Disability Review Specialist (DRS) to manage the full lifecycle of disability review service requests. The ideal candidate is an excellent communicator with strong grammar, exceptional organizational skills, and the ability to manage multiple deadlines in a fast-paced, team-based environment.

The DRS serves as the primary liaison between the referring party, Physician Reviewer, and Quality Nurse Reviewer (QNR), ensuring disability review services are completed accurately, compliantly, and on time.

Key Responsibilities

Case Intake & Review Coordination

• Receive and process initial disability review service requests from referring parties
• Review cases to determine correct service type and verify required documentation
• Identify and document any real or perceived conflicts of interest in accordance with corporate policy
• Confirm appropriateness and clarity of clinical review questions

Physician Reviewer Coordination

• Select appropriate Physician Reviewer(s) based on:
  • Availability within required timelines
  • Specialty matching client request and clinical review needs
  • Client pricing requirements
• Maintain ongoing communication with Physician Reviewers to ensure timely and accurate report completion

Report Preparation & Delivery

• Create appropriate DR report templates for Physician Reviewer completion
• Coordinate scheduling and service timelines
• Communicate status updates and delays (if applicable) to referring parties
• Finalize reports following QNR approval
• Deliver completed reports to referring parties

Documentation, Billing & Compliance

• Accurately document all case activities
• Enter Physician Reviewer costs and client charges for invoicing approval
• Protect confidential patient information in compliance with corporate confidentiality policies
• Seek clinical direction when appropriate
• Perform other duties as assigned

Required Qualifications

• High School Diploma or GED
• Minimum 2 years of related professional experience
• Excellent written and verbal communication skills
• Strong grammar and professional communication style
• Strong customer service skills
• Working knowledge of Microsoft Office and database systems
• Knowledge of medical terminology
• Experience handling confidential and sensitive information
• Ability to work under pressure and manage multiple competing deadlines

Preferred Qualifications

• Advanced computer and data entry skills
• Minimum 1 year experience providing telephonic customer service and data entry in a medical or clinical environment
• Experience working within structured policy and procedure environments

Core Competencies

• Detail-oriented and highly organized
• Timely, dependable, and accountable
• Strong team collaboration skills
• Professional and polished communication presence
• Ability to prioritize and problem-solve in time-sensitive situations

Work Environment & Physical Requirements (ADA)

• Standard office environment
• Sedentary work classification (U.S. Department of Labor definition)
• Primarily seated work with occasional standing or walking
• Occasional lifting or moving of up to 10 pounds
• Periods of increased workload and deadline pressure may occur

If you're someone who thrives in structured, detail-heavy workflows and enjoys coordinating between clinical professionals and clients, we encourage you to apply.