Case Completion Coordinator (Remote)

Description

WHO WE ARE

Founded in 1983, the Medical Review Institute of America (MRIoA) is the market leader for technology-enabled utilization management and clinical medical review solutions. We have an outstanding reputation for excellence and achieve continual improvement.

 

At MRIoA, we believe our employees are the key to our success. Here, you are more than just a cog in the machine – you are a valued member of our team.

WE OFFER

• A competitive compensation package.
• Benefits include healthcare, vision and dental insurance, a generous 401k match, paid vacation, personal time, and holidays.
• Growth and training opportunities.
• A team atmosphere with fun events and prizes scheduled throughout the year.

POSITION OVERVIEW

Our Case Completion Coordinator is responsible to carry out day-to-day departmental tasks and complete all processes for receiving and reviewing reviewer decisions, issuing appropriate, timely and accurate review outcome notifications and maintaining online case summary/tracking information.

Roles:

• To finalize the case review process and issue review outcome notifications to appropriate parties of the case
• To serve as a company liaison with clients, reviewers and practitioners/providers/ facilities whose services are subject to review

Major Responsibilities or Assigned Duties:

• Evaluate opinions submitted by reviewers upon conclusion of their reviews for compliance with company standards for completeness 
• Follow-up with reviewers whose submitted opinions do not meet all compliance standards
• Issue oral and written review outcome notifications that comply with standards and requirements for timeliness, content, recipients and accuracy including written notification, grammar and spelling
• Research clients’ questions about review processes and/or reviewer decisions 
• Determine need for additional information or additional review and notify the client and internal departments of these needs
• Provide backup support to staff in other areas as applicable
• Support all Quality Management initiatives
• Actively participate in the Complaint Process and Provider Relations Assessment process
• Support all Compliance Program activities
• Participate in all company meetings and committees as requested
• Maintain a flexible schedule to meet client needs
• Adhere to all policies and procedures
• Take feedback and responsibility for performance
• Adapt to differences of clients
• Complete other duties and responsibilities as directed

Position Levels

Each level attained compounds responsibilities with those of prior levels

Analyst I-IV & Auditors meet or exceeds the goals for the respective level:

• Training period to last from date of hire to an estimated 6 months*
• Production should increase regularly, with expected career path benchmarks
• Quality should increase regularly, with expected career path benchmarks
• Adherence to all policies and procedures
• Takes feedback and responsibility for performance
• Adapts to the differences of clients

California Consumer Privacy Act (CCPA) Information (California Residents Only):

• Sensitive Personal Info: MRIoA may collect sensitive personal info such as real name, nickname or alias, postal address, telephone number, email address, Social Security number, signature, online identifier, Internet Protocol address, driver’s license number, or state identification card number, and passport number.
• Data Access and Correction: Applicants can access their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at HR@mrioa.com. 

Requirements

Skills and Experience: 

• Ability to work under pressure and meet deadlines while managing multiple high priorities 
• Personal computer literacy and high competency in use of MS Word and ten key 
• Strong detail orientation
• Strong organizational skills
• Strong oral and written communication skills
• Well-developed customer service and training skills
• Working knowledge of basic anatomy, physiology and medical terminology
• Ability to work independently with minimal supervision
• Understanding and knowledge of company's clients, products, departments and workflows departments, and applicable regulatory requirements and accreditation standards

Experience:

• Minimum one