Advanced Medical Reviews

QA Engineer

• Receive client submissions and input client and examinee data in the system.
• Verify all cases contain information needed for the clinical review process.
• Maintain daily contact with the Clinical QA Department regarding workflow and status of pending reports.
• Track documentation of all processes, communications, report status and due dates.
• Maintain a daily log of files that require follow up, clarification or concerns in the tracker.
• Receive completed reports and review for completeness and accuracy, including proper formatting, grammar and sentence structure.
• Complete and or ensures all invoicing is billed daily and in accordance with company practices and client contract agreements.
• Handle and respond promptly to incoming communication from physicians or clients requesting report status or information.
• Work with transcriptionists and/or physicians’ offices regarding report details, clarification, addendums, etc.
• Ensure all medical records and reports are properly documented and saved in the appropriate location.
• Notify management of any report issues or concerns.
• Ensure all practices are carried out in accordance with HIPAA compliance practices, state and federal safety standards and legal regulations.
• Promote effective and efficient utilization of clinical resources and supplies.
• Perform other duties as assigned.

Clerical Quality Assurance Coordinator

Case Coordinator

• 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
• Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists
• Assists in resolution of customer complaints and quality assurance issues as needed