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Medical Review Coordinator

Location: Portland, OR
Job Code: 342
# of Openings: 2

Description

MEDICAL REVIEW COORDINATOR

AllMed Healthcare Management’s mission is to improve the quality and integrity of healthcare by providing independent medical review services that help payers and providers deliver better health outcomes. We provide pre-authorization and appeals decision-making services through PeerPoint®, AllMed’s state-of-the-art Medical Review Portal.  We partner with over 300 leading US health insurance and hospital organizations and have maintained consistent 20% annual growth, through our commitment to the highest quality, client satisfaction, and technology innovation.  We have undergone a lean transformation, driving continuous improvement in our performance.  As a result, AllMed’s client list includes many of the nation’s top names in healthcare.

We are seeking a Medical Records Coordinator to join our Clinical Operations team. This is a full-time opportunity that is currently working remotely, but will ultimately be located in our downtown Portland, OR office.

POSITION DESCRIPTION

The Medical Review Coordinator can be relied upon for multiple functions within the Clinical Operations Department. The primary job functions entail organizing clinical information and review criteria for peer review and securing peer reviewers to ensure timely completion; verifying adherence to operational processes and documentation/style guidelines; and maintaining a balance of accuracy and speed. Duties and responsibilities include:

  • Maintaining effective rapport and positive, professional communication with other staff members, professional support staff, administrators, and clients
  • Ensuring accuracy of book-marking clinical records, case preparation and/or dispatch in an efficient manner
  • Maintaining a balance of accuracy and speed in the preparation and/or dispatch of cases
  • Communicating any case specific issues to the relevant team members
  • Problem solves case assignment or case prep issues and escalates to supervisor/manager when needed
  • Answering and routing incoming phone calls as needed
  • Participating in cross functional teams and Lean continuous improvement activities including root cause identification and problem solving to improve processes
  • Maintaining confidentiality and privacy as defined by state, federal, and company regulations and policies
  • Participates in preliminary steps of the clinical review preparation process which includes entering cases into PeerPoint, evaluating incoming cases, reviewing questions, verifying receipt of appropriate clinical information, scanning and attaching documents to cases, researching prior reviews and logging all special review requests per standard work
  • Preparing and organizing clinical information and review criteria for peer review
  • Ensure accurate and efficient compression and organization of medical records to eliminate duplicate and extraneous information for our peer reviewers
  • Responds to all rejected or neglected cases and monitors queues to ensure reviews are completed on time
  • Participates in the peer reviewer performance feedback system and utilizes data for assigning cases
  • Grows and maintains professional relationships with Peer Reviewers

KNOWLEDGE, SKILLS, ABILITIES, EXPERIENCE

  • A high school degree or equivalent is required; Associate or Bachelor’s degree in a healthcare related area is preferred
  • Knowledge and understanding of medical terminology
  • One year’s related experience in a clinical administrative capacity, clinical office, or health plan utilization management environment
  • A strong customer service orientation and teamwork ethic
  • Computer literacy with demonstrated proficiency in Microsoft Office
  • Experience with web-based application software preferred
  • Competence in handling office equipment
  • Ability to type at least 40 words per minute
  • Ability to manipulate documents (example: converting PDF to Word, Word to PDF)
  • Possess a strong customer service orientation
  • Superior accuracy and attention to detail; critical eye to catch mistakes
  • Ability to prioritize tasks and quickly shift priorities in response to changing circumstances
  • Excellent learning and memory skills, leading to the ability to capture and retain a wide variety of operational and client-specific requirements
  • High energy and the ability to work at a fast pace in a volume-oriented production environment
  • Outstanding interpersonal skills, including all forms of communications, and ability to negotiate with peers

 

BENEFITS

AllMed offers generous compensation and our competitive benefits program includes comprehensive medical, vision and dental care, matching 401K, paid time off, HSA accounts, disability coverage, and other benefits that help provide for our employees.

 

AllMed provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, AllMed complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities.





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(800) 400-9916
111 SW Fifth Ave., Suite 1400, Portland, OR 97204
AllMed Healthcare Management, Inc. All rights reserved.

AllMed is an independent review organization with a panel of 400 physician peer reviewers who are licensed, board-certified and in active practice, covering more than 80 ABMS specialties and sub-specialties. AllMed offers medical, copy-editing and customer resources that enable clients to improve quality of care and patient safety.