Medical Case Reviewer, PHRN

Role Overview

• Accountable for daily management of assigned cases, adhering to client turnaround time
• 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
• Assists in the creation of process-related templates, if needed

Requirements

• 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

Benefits

• Must be able to work independently, with minimal supervision
• Must be flexible in work schedule changes
• Must be accountable for all assigned cases