Physician Advisory Services QA Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Deliver regular status update reports to clients

• Assess physician reports for quality, client specifications, jurisdictional standards, and clinical justification

• Resolve unclear report queries with clients

• Distribute final reports according to client-specific instructions

• Manage clarification and addendum requests

• Attend client calls or meetings when reports are under scrutiny

• Follow up with clients for any missing referral information

• Collaborate directly with physicians to ensure client inquiries are addressed with clinical justification

• Coordinate with physicians or office personnel to guarantee timely report delivery

• Provide verbal or written feedback and clarification requests to physicians

• Secure physician approval and signature for final reports

• Review reports for data precision, spelling, grammar, and punctuation

• Ensure compliance with state reporting requirements and client-specific formatting standards

• Adhere to special handling instructions for report completion and delivery

• Offer guidance to team members when necessary

• Enhance processes to improve turnaround time, peer-to-peer success rates, and client satisfaction

• Grant final approval for case releases to clients

• Coordinate with the VP of Clinical Operations regarding quality issue reports and new reviewer reports

• Undertake additional responsibilities and special projects as assigned

⛳️ Requirements

• Associate’s Degree or Bachelor’s Degree is preferred

• Experience in a healthcare or insurance environment is preferred

• Superior communication skills

• Clear understanding of the company's business lines

• Ability to apply critical thinking skills

• Capability to manage time effectively and meet deadlines

• Proficiency in computer skills and typing

• Must have personal internet services and support

• Reliable internet connection is required for remote work

• Ability to perform necessary lifting, bending, traveling, prolonged sitting, and computer tasks

🏝️ Benefits

• Medical, dental, and vision insurance for employees and their families

• Optional life insurance for employees, spouses, and children

• Optional plans for hospital indemnity, critical illness, accident indemnity, and pet insurance

• Basic life insurance provided at no cost

• Short-term disability coverage at no cost

• Long-term disability coverage at no cost

• Generous paid time off policy

• 401k plan with company contribution

• Apple equipment provided for remote work setup

• Media stipend for remote work expenses