Health Completion Analysis (Fully Remote)

Description

Who We Are

Founded in 1983, the Medical Review Institute of America (MRIoA) is the market leader for technology-enabled utilization management and clinical medical review solutions. We have an outstanding reputation for excellence and achieve continual improvement.

At MRIoA, we believe our employees are the key to our success. Here, you are more than just a cog in the machine – you are a valued member of our team.

What We Offer

• A competitive compensation package.
• Benefits include healthcare, vision and dental insurance, a generous 401k match, paid vacation, personal time, and holidays.
• Growth and training opportunities.
• A team atmosphere with fun events and prizes scheduled throughout the year.

Position Summary:

A Health Completion Analyst is responsible for helping finalize the health case review process and issuing review outcome notifications to the appropriate parties.

Roles

• To finalize the health case review process and issue review outcome notifications to the appropriate parties of the case.
• To serve as a company liaison with clients, Reviewers, and practitioners/providers/ facilities whose services are subject to review.

Major Responsibilities or Assigned Duties

• Screen incoming requests and analyze them for completeness and correctness.
• Follow workflow procedures to provide nurses with cases that are ready to be worked with all necessary information.
• Contact clients/MRIoA staff/providers/facilities as needed to resolve questions, obtain information, records and/or materials needed for case review and to resolve issues about active cases.
• Respond to reviewer requests for additional information/materials necessary for a review and notify clients and other internal departments of these needs, as applicable.
• Monitor queues, spreadsheets, chats or perform other tasks to as requested.
• Collaborate with nursing staff to resolve issues on active cases.
• Provide backup support to staff in other areas as applicable.
• Participate in all company meetings and committees as requested.
• Maintain a flexible schedule to meet client needs.
• Complete other duties and responsibilities as directed.

Requirements

Skills and Experience:

• Minimum of 1 year of Healthcare Insurance, medical terminology, or Pharmacy experience
• Ability to work in a fast-paced and high-functioning environment and meet deadlines while managing multiple high-priorities
• Ability to work independently with minimal supervision
• Personal computer literacy and high competency in the use of Microsoft Office
• Strong organizational skills with strong attention to detail
• Excellent critical thinking capabilities
• Strong oral and written communication skills
• Outstanding customer service skills

Education:

• High school diploma or equivalent

Work Environment:

Ability to sit at a desk, utilize a computer, telephone, and other basic office equipment is required. This role is designed to be a remote position (work-from-home).

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.



This company is a drug-free workplace. All candidates are required to pass a Background Screen before beginning employment. All newly hired employees will take a Drug Screen, as well as agreeing to all necessary Compliance Regulations on their first day of employment.