Operations

Medical Case Reviewer PHRN (Remote)

Remote
Work Type: Full Time

Responsibilities: 

 

  • Accountable for daily management of assigned cases, adhering to client turnaround time, and department Standard Operating Procedures. 

  • Complete preliminary review of medical cases ensuring all tasks are completed in a timely fashion. 

  • Maintain productivity standards with speed and accuracy. 

  • Support non-clinical staff with clinically related questions or issues that arise related to case review. 

  • If needed, actively cross-trains to perform reviews of multiple case types to provide a flexible workforce to meet client needs. 

  • Assist team members with questions, participates in team meetings. 

  • Participates in ongoing training programs to ensure quality performance in compliance with applicable standards and regulations. 

  • Recommend new methods to improve departmental procedures. 

  • Follows company policies and procedures 

  • Respects and maintains HIPAA confidentiality guidelines. 

  • Must be able to work independently, with minimal supervision. 

  • Must be flexible in work schedule changes, as needed. 

  • Must be accountable for all assigned cases. 

  • Assists in the creation of process-related templates, if needed. 

  • Other duties as assigned 

Qualifications: 

  • A Bachelor's degree in Nursing; Preferably PHRN and holds an active PH License 

  • Preferably with experience in the use of EMR and doing medical summaries. 

  • Good computer skills and the ability to use business support software. 

  • Project management, and quality control skills. 

  • Good resource planning skills. 

  • Strong teamwork skills and attention to detail. 

Computer specs Requirement (work from home set up):

  • Fiber connection and has at least 20mbps download and upload speed
  • Has available backup internet minimum of 15mbps download and upload speed
  • Main desktop/laptop must be i5 to i7 w/ 8GB RAM ; 4th generation and above
  • Backup desktop/laptop must be i3 to i5 w/ 8GB RAM ; 4th generation and above

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