LivantaLLC

Peer Review Administrator

LivantaLLC

full-time

Posted on:

Location Type: Remote

Location: Remote • 🇺🇸 United States

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Salary

💰 $75,000 - $80,000 per year

Job Level

Mid-LevelSenior

Tech Stack

Cloud

About the role

  • Serves as the primary liaison between the Company and the Peer Reviewer panels required for Commence’s contract work
  • Relays questions, concerns, and other operational information between the Medical Director, Project Director(s), and Peer Reviewers
  • Assists in the day-to-day maintenance of Commence’s required Peer Reviewer panels
  • Manages onboarding and offboarding of all new PRs, including background check paperwork, licensing check, W-9 completion, Small Business Certification (if required), access requests, input of rates into CompassWeb and distribution of training materials
  • Ensures that each new PR has a signed contract on file and computer access to perform the job
  • Ensures that each PR has access to each internal and government platform and instruct them on how to set up those accounts
  • Follows up on all recruitment leads from all sources, including the current panel(s)
  • Prepares agreements for each new PR, ensuring that the correct agreement template is used, and that the required credentials are added properly
  • Initiates and monitors PR training on computer systems and Company procedures
  • Maintains a master database available to managers and staff of all active and past PRs and their contact information, states of license, specialties, onboarding progress, small business types, case preferences, and language proficiency
  • Prepares monthly PR reimbursement reports
  • Maintains a monthly running tab of PR reimbursements to stay within contract limits
  • Serves as the point of contact for PR payment issues, including billing and reimbursement issues
  • Performs and documents yearly licensure, board certification, and other required verifications
  • Serves as the point of contact for business development on PR questions
  • Ensures the Medical Director and Project Director(s) are kept informed and up to date on the status of the PRs to include contract status and any issues with PRs and onboarding and offboarding status
  • Protects the confidentiality of patient information through compliance with the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH)
  • Completes annual security awareness training and testing, rules of conduct training, and conflict of interest training
  • Assists in recruiting specialists as needed, via mailings to medical societies, training program inquiries, etc.
  • Distributes PR educational material
  • Continually updates the database of teaching material and Medical Director letters to the PR panel
  • Provides administrative support for the medical director, including set-up and maintaining internal quality control (IQC) cases for monthly medical director quality review

Requirements

  • An associate degree plus three years of experience OR Bachelor’s degree plus two years of experience related to a majority of the essential functions of the job
  • Experience and skills in processing Excel spreadsheets and using presentation software applications
  • Familiarity with database software programs (e.g., Microsoft Office)
  • Ability to use multiple cloud-based platforms
  • Knowledge of the health care system, the health professions, and the medical specialties
  • Licensed Practical Nurse (LPN) or Registered Nurse (RN) licensure is preferred but not required
  • Excellent written and verbal communication skills
  • Ability to compose and edit various complex documents and ensure that documents are grammatically correct and error-free
  • Strong analytical ability and problem-solving skills
  • Ability to work as a team member by maintaining good working relationships with co-workers, management, and customers
  • Ability to organize and coordinate multiple simultaneous tasks in a team environment
  • Ability to work independently with minimal supervision
  • Additional hours may be required, with flexibility to adjust schedule with little or no notice
Benefits
  • Equal employment opportunity employer
  • Provides reasonable accommodations for individuals with disabilities

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills
Exceldatabase softwarecloud-based platformsdocument compositionanalytical skillsproblem-solving skillsonboarding processesbackground checkscontract managementreimbursement reporting
Soft skills
written communicationverbal communicationteamworkorganizational skillsindependenceflexibilityrelationship managementattention to detailtraining facilitationconfidentiality
Certifications
Licensed Practical Nurse (LPN)Registered Nurse (RN)
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