Case Coordinator (31220)

ExamWorks is looking for a Case Coordinator to join our team onsite!

The Case Coordinator is responsible to ensure reports are of the highest quality and integrity and in full compliance with client contractual agreement, regulatory agency standards and/or federal and state mandates. This position is required to assist with quality assurance questions and provide overall support to the Quality Assurance Department. IME experience is preferred but not required.

Our work hours are from Monday to Friday, 8:00am-5:00pm. This is on onsite role, located at our Dallas, Texas location.

We offer a competitive pay of $17-20 per hour depending on experience.

Our Culture - We believe in a culture of respect and openness. We operate a fast paced, high volume business and value the contributions and partnership of our employees. We have a stable workforce and are looking for employees who have a good work ethic and can operate well in a team environment. While we are heavily focused on work and meeting our clients' expectation and deadlines, we still take time to enjoy the little things, with periodic office lunches and celebrations.

What do we do? ExamWorks is a growing and profitable leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Performs quality assurance review of reports, correspondences, addendums or supplemental reviews.
• Ensures clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations.
• Ensures that all client instructions and specifications have been followed and that all questions have been addressed.
• Ensures each review is supported by clinical citations and references when applicable and verifies that all references cited are current and obtained from reputable medical journals and/or publications.
• Ensures the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards.
• Ensure that the appropriate board specialty has reviewed the case in compliance with client specifications and/or state mandates and is documented accurately on the case report.
• Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists.
• Ensures the provider credentials and signature are adhered to the final report.
• Identifies any inconsistencies within the report and contacts the Peer Reviewer to obtain clarification, modification or correction as needed.
• Assists in resolution of customer complaints and quality assurance issues as needed.
• Ensures all federal ERISA and/or state mandates are adhered to at all times.
• Provides insight and direction to management on consultant quality, availability and compliance with all company policies and procedures and client specifications.
• Promotes effective and efficient utilization of company resources.
• Participates in various educational and or training activities as required.
• Performs other duties as assigned.
  
  

• 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.
• Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values.
• Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
• Must possess excellent skills in English usage, grammar, punctuation and style.
• Demonstrates accuracy and thoroughness. Looks for ways to improve and promote quality and monitors own work to ensure quality is met.
• Must be able to maintain confidentiality.
• Must be able to demonstrate and promote a positive team-oriented environment.

ExamWorks is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.