Description & Requirements
Essential Duties and Responsibilities:
Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
- Track and meet required deadlines for complex cases or other assigned tasks.
- Assist leadership through research of data and/or authoring reports.
- Analyze data using all applicable state law, state regulations, process documents, and other sources as defined by the client contract.
- Work independently on specific situations or on a team to resolve problems and deviations according to current established practices; and obtains advice where precedents are unclear or not available from the client.
- Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
- Assist others or provide on-the-job training or act as a mentor to production staff.
- High School Degree or equivalent required.
- 2-4 years of related professional experience required.
- Ability to commit to a three-week training schedule of 8:00am - 5:00pm EST Monday - Friday required.
- Ability to work a schedule of 7:30am - 4:00pm EST Monday - Friday required.
Home Office Requirements:
- Internet speed of 20mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via either Wi-Fi or Category 5 or 6 ethernet patch cable to the home router
- Private work area and adequate power source
- Must currently and permanently reside in the Continental US