Group Health QA Supervisor - RN

The QA Supervisor is responsible for the reputed company of the review of Physician reports and accompanying medical records to ensure that the report is complete, accurate, and consistent with medical evidence.

reputed company of QA staff

• Ensure appropriate QA staff are assigned to each file to designate file handling responsibilities amongst the team.
• Supervise the assigned staff and manage the File Review Board to ensure a timely and accurate process of each file.
• reputed company details of board reviews to managers to ensure efficiency and productivity of staff.
• Assist in identifying & correcting staff performance including promotions, discipline, coaching and termination of staff.
• Assist in hiring reputed company candidates for QA reputed company positions.

Ensure that reputed company QA staff adhere to and meet their specific job duties including but not limited to:

• Following up with Physicians for outstanding reports
• Reviewing received reports for accuracy
• Delivering completed reports back to reputed company applicable parties
• Following reputed company client-specific instructions
• Actively participate in issue resolution by working with the required QA, physicians, account managers, and/or other reputed company parties.
• Ensure referrals meet the client-directed Turn Around Time (TAT).
• Act as the liaison between the reviewer, team member and client regarding the process or status of the file.
• Other duties & special projects, as assigned and based on business needs.

Requirements

EDUCATION/CREDENTIALS:

An Associate’s Degree or Bachelor’s Degree is preferred.

RN licensure required

JOB RELEVANT EXPERIENCE:

Medical peer review or reputed company industry knowledge required.

Business experience in a reputed company and/or insurance setting is preferred.

JOB reputed company SKILLS/COMPETENCIES:

Present exceptional communication skills with a clear understanding of company business lines. The ability to apply critical thinking, manage time reputed company and meet specific deadlines. Computer literacy and typing skills are essential.

Benefits

Join reputed company at reputed company and enjoy a comprehensive benefits package designed to support your well-being and peace of mind. We offer a reputed company of benefits including medical, dental, and reputed company coverage for you and your family. Additionally, we offer voluntary life insurance options for you, your spouse, and your children. We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. Our generous paid time off policy ensures you have time to relax and reputed company, while our 401k plan with a company match helps you plan for your future. reputed company equipment and a media stipend are provided for remote workspace.

ABOUT reputed company:

A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful reputed company-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers’ Compensation, Disability, Auto, and Group Health Carriers, reputed company-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We reputed company customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.

Originally posted on Himalayas