Clinical Review Coordinator - Remote

Overview

The Clinical Review Coordinator conducts mandatory case reviews and quality assurance activities, ensuring timely and accurate processes while working remotely from the Las Vegas, NV area.

In Short

• Conducts case reviews and quality assurance activities.
• Ensures timely and accurate review processes.
• Maintains responsibility for efficient case review.
• Communicates with physician reviewers and supports them.
• Informs stakeholders about Quality Improvement Organization activities.
• Edits documentation for various audiences.
• Protects patient confidentiality in compliance with HIPAA.
• Performs desktop medical reviews.
• Acts as a liaison for beneficiaries and provides education.
• Collaborates on healthcare improvement projects.

Requirements

• Detail-oriented with clinical knowledge of medical terminology.
• Graduation from an accredited nursing school (RN or LPN).
• Experience with Medicare QIO and quality of care reviews.
• Minimum of two to four years in clinical decision-making for Medicare patients.
• Ability to organize and coordinate multiple tasks.
• Strong problem-solving skills and objectivity.
• Excellent communication skills, both verbal and written.
• Ability to work independently with minimal supervision.
• Knowledge of healthcare systems and beneficiary rights.
• Must notify HR of any changes to licensure status.

Benefits

• Competitive salary.
• Remote work flexibility.
• Professional development opportunities.
• Supportive work culture.
• Comprehensive benefits package.