Medical Review Coordinator

1 month ago

Oak Brook, United States Zenith American Full time
Job DescriptionJob Description

Title: Medical Review Coordinator Department: Pension

FLSA: Non-exempt Hours: 40

Union: UFCW 1546 Grade: 23

Date Posted: 02/28/2024


Position Summary

The Medical Review coordinator ensures documentation needed for medical review is complete and accurate in accordance with Company policies, regulatory requirements, and plan guidelines.

"Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role."


Key Duties and Responsibilities

  • Maintains current knowledge of assigned Plan(s).
  • Assembles documentation needed to substantiate retirement benefits claims.
    • Reviews documentation submitted to ensure accuracy and completeness.
    • Coordinates with processors to obtain missing or incomplete documentation.
    • Forwards completed documentation to third party vendor for medial review.
    • Handles files in a sense of urgency
  • Acts as clinical resource to the department.
  • Conducts special reviews as needed by the client.
  • Performs other duties as assigned.


Minimum Qualifications

  • High school diploma or GED
  • One year of experience working in healthcare.
  • Knowledge of medical terminology CPT, ICD-10 diagnosis codes.
  • Understanding of confidentiality in dealing with sensitive and personal information.
  • Excellent organizational skills with an attention to detail.
  • Excellent communication skills; comfortable interacting with all levels of an organization and its external partners.
  • Timely work performance
  • Critical thinking skills
  • Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations.
  • Proficiency with MS Office tools and applications

Preferred Qualifications

  • Familiarity with third party administrators and Taft-Hartley retirement funds
  • Experience with retirement plan disability provisions.
  • Current ARNP or LPN license

*Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee of this job. Duties, responsibilities and activities may change at any time with or without notice.


Working Conditions/Physical Effort

  • Prolonged periods of sitting at a desk and working on a computer.
  • Must be able to lift up to 15 pounds at times.

Disability Accommodation

Consistent with the Americans with Disabilities Act (ADA) and other applicable federal and state law, it is the policy of Zenith American Solutions to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment, including the application process. If reasonable accommodation is needed, please contact the Recruiting Department at recruiting@zenith-american.com, and we would be happy to assist you.


ZAS's Mission, Vision & Values

As a member of the ZAS team, each employee agrees to embrace and live out the mission, vision and core values of ZAS. The values we live and work by are:

  • We focus on relationships
  • We take risks thoughtfully
  • Ethical behavior
  • Performance and accountability
  • We strive to win, but not at all costs

Zenith American Solutions, Inc.

Real People. Real Solutions. National Reach. Local Expertise.

Zenith American Solutions, Inc. is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. The original entity of Zenith American has been in business since 1944.

We believe the best way to realize our better systems for better service philosophy is to hire the best employees. We look for talented individuals who share our dedication to high-quality work, exceptional service and mutual respect. If you're interested in working in an environment where people - employees and clients - really matter, consider bringing your talents to Zenith American

Internals to Apply:

If you meet the minimum qualifications and are interested in applying for this position, please submit an application. All applications must be received by 5:00 pm on the Internal Posting Deadline in order to be considered prior to external applicants.


* Zenith American Solutions is an Equal Opportunity Employer. Zenith does not discriminate on the basis of race, religion, color, sex, physical or mental disability, gender identity, sexual orientation, age, national origin, pregnancy, status as a parent, veteran status or any other basis covered by appropriate law. All employment decisions on the basis of qualifications, merit, and business need.



Job Posted by ApplicantPro

  • Medical Review Coordinator

    3 weeks ago

    Oak Brook, United States Zenith American Full time

    Title: Medical Review Coordinator Department: Pension FLSA: Non-exempt Hours: 40 Union: UFCW 1546 Grade: 23 Date Posted: 02/28/2024 Position Summary The Medical Review coordinator ensures documentation needed for medical review is complete and accurate in accordance with Company policies, regulatory requirements, and plan guidelines. "Has minimum necessary...

  • Medical Review Coordinator

    4 weeks ago

    Oak Brook, United States Zenith American Full time

    Job DescriptionJob DescriptionTitle: Medical Review Coordinator Department: PensionFLSA: Non-exempt Hours: 40Union: UFCW 1546 Grade: 23Date Posted: 02/28/2024Position SummaryThe Medical Review coordinator ensures documentation needed for medical review is complete and accurate in accordance with Company policies, regulatory requirements, and plan guidelines....

  • Administrative Medical Review Coordinator

    1 week ago

    Oak Brook, United States Zenith American Full time

    **Title**:Medical Review Coordinator** Department**:Pension **FLSA**:Non-exempt** Hours**:40 **Union**:UFCW 1546** Grade**:23 **Date Posted**:02/28/2024 **Position** **Summary** The Medical Review coordinator ensures documentation needed for medical review is complete and accurate in accordance with Company policies, regulatory requirements, and plan...

  • Administrative Medical Review Coordinator

    1 month ago

    Oak Brook, United States Zenith American Full time

    Title: Medical Review Coordinator Department: Pension FLSA: Non-exempt Hours: 40 Union: UFCW 1546 Grade: 23 Date Posted: 02/28/2024 Position Summary The Medical Review coordinator ensures documentation needed for medical review is complete and accurate in accordance with Company policies, regulatory requirements, and plan guidelines. "Has minimum necessary...

  • Senior Manager: Peer Review

    2 weeks ago

    Oak Brook, United States Radiological Society of North America Full time

    Job DescriptionJob DescriptionWhat we're looking for: We are seeking a motivated professional responsible for managing peer review for one RSNA journal, including overseeing journal peer review team and queues; communicating manuscript statuses to Managing Editor and Editor: assigning peer reviewers; corresponding with authors, reviewers, and Deputy...

  • Credentialing Coordinator

    2 months ago

    Oak Brook, United States Athletico Physical Therapy Full time

    The Credentialing Coordinator reviews applications, prepares verification letters, and contacts clinical staff and insurance carriers to ensure that all active providers have completed applications and credentialing/re-credentialing information on fi Credentialing, Coordinator, Healthcare, Business Services, Enrollment, Application

  • Regulated Substances Coordinator

    3 weeks ago

    Oak Brook, United States GZA GEOENVIRONMENTAL INC Full time

    As a Regulated Substances Coordinator, you will work with a fast-paced team of Scientists, geologists, and Engineers working on Illinois Department of Transportation projects for District 1. **This role will be an embed role at the IDOT District 1 office assisting the District 1 Environmental Studies Unit.** We are seeking the Regulated Substances...

  • Mds Coordinator

    3 weeks ago

    Oak Brook, United States American Medical Associates Full time

    **MDS Coordinator** needed for a skilled nursing facility located in **Oak Brook, IL**!!!! **_ *Salary: up to $110K (based on experience)*_** **Qualifications**: - Must have current IL RN License - Must have MDS Coordinator experience - Must have long term care experience - Must have excellent leadership skills - Must know MDS...

  • Regulated Substances Coordinator

    2 weeks ago

    Oak Brook, United States GZA GeoEnvironmental Full time

    Huff & Huff, Inc. a subsidiary of GZA (H&H/GZA) is currently seeking a Regulated Substances Coordinator from two to four years' experience to support our environmental practice in our Oak Brook, Illinois office.The successful candidates will have a solid educational background and must be self-motivated with a professional attitude. As a Regulated Substances...

  • Claims Compliance Coordinator

    2 weeks ago

    Oak Brook, United States lions clubs international Full time

    **We’re in the business of **Good.** Lions Clubs International is the largest service club organization in the world. Our 1.4 million members are serving locally and globally to help take on some of the biggest challenges facing humanity. Every Lion and club are supported by our international association. More than 300 Lions International staff members...

  • Store Planning Coordinator

    3 weeks ago

    Oak Brook, United States ACE Hardware Full time

    About This Role The Store Planning Coordinator will be responsible for assisting the Store Planning team in the set-up of capital projects - both for new stores and for existing store remodels. The coordinator will complete the intake of projects, facilitate scheduling with our outside measuring company, prepare files in AutoCAD and JDA for the store...

  • Facilities Coordinator

    3 weeks ago

    Oak Brook, United States Portillos's Full time

    Facilities coordinators oversee building and equipment maintenance. Their duties include scheduling preventative maintenance tasks and reacting to maintenance emergencies. They may also be required to determine equipment and supply needs for new buildings. Responsible for resolving issues and/or initiating service calls and scheduling vendors for restaurant...

  • Facilities Coordinator

    2 weeks ago

    Oak Brook, United States Portillo's Full time

    Facilities coordinators oversee building and equipment maintenance. Their duties include scheduling preventative maintenance tasks and reacting to maintenance emergencies. They may also be required to determine equipment and supply needs for new buildings. Responsible for resolving issues and/or initiating service calls and scheduling vendors for restaurant...

  • Hospice Hospital Care Coordinator

    7 days ago

    Oak Brook, United States Trinity Health At Home Full time

    **Employment Type**: Full time **Shift**: Day Shift **Description**: See job description **_ Position Purpose:_** Responsible for: Home Care/Hospice Coordinator the efficient and effective facilitation of referrals to the post-acute homecare/hospice agency once identified in the acute care setting; the provision of education to acute care staff, including...

  • Human Resources Coordinator

    4 weeks ago

    Oak Brook, United States The Drake Oak Brook, Autograph Collection Full time

    **What’s in it for you**: - Insurance enrollment available from DAY 1! - Paid time off available from DAY 1! - Holiday pay available from DAY 1! - 401(k) enrollment after 30 days! - Hotel and travel discounts at worldwide destinations! - Professional development and promotion opportunities! **The impact you’ll make**: The Human Resources Coordinator...

  • Human Resources Coordinator

    5 hours ago

    Oak Brook, United States The Drake Oak Brook, Autograph Collection Full time

    **What’s in it for you**: - Insurance enrollment available from DAY 1! - Paid time off available from DAY 1! - Holiday pay available from DAY 1! - 401(k) enrollment after 30 days! - Hotel and travel discounts at worldwide destinations! - Professional development and promotion opportunities! **The impact you’ll make**: The Human Resources Coordinator...

  • HR Coordinator

    4 days ago

    Oak Brook, United States Inland Devon Self Storage Full time

    **About Devon Self Storage** Devon Self Storage, one of the largest privately owned national self-storage developers and operators, manages over 117 properties and approximately 91,400 units nationally. Founded in 1988 by Ken Nitzberg, and now a member of The Inland Real Estate Group of Companies, Inc., Devon has established itself as a leader in the...

  • Administrative Medical Coordinator

    3 weeks ago

    Stony Brook, United States SB Clinical Practice Management Full time

    Overview: **Administrative** Medical Coordinator - **Stony Brook Children’s Service, UFPC** **Location: Stony Brook, NY** **Schedule: Full Time** **Days/Hours**:Monday - Friday; 8:30 AM - 5 PM **Pay: $21.92 - $27.40** Our compensation philosophy aims to provide marketable compensation programs and to compensate employees based on relevant experience...

  • Human Resources Coordinator

    4 weeks ago

    Oak Brook, United States The Drake Oak Brook, Autograph Collection Full time

    What’s in it for you… Insurance enrollment available from DAY 1! Paid time off available from DAY 1! Holiday pay available from DAY 1! 401(k) enrollment after 30 days! Hotel and travel discounts at worldwide destinations! Professional development and promotion opportunities! The impact you’ll make…The Human Resources Coordinator performs a critical...

  • Human Resources Coordinator

    4 weeks ago

    Oak Brook, United States The Drake Oak Brook, Autograph Collection Full time

    What’s in it for you… Insurance enrollment available from DAY 1! Paid time off available from DAY 1! Holiday pay available from DAY 1! 401(k) enrollment after 30 days! Hotel and travel discounts at worldwide destinations! Professional development and promotion opportunities! The impact you’ll make…The Human Resources Coordinator performs a critical...