Independent Medical Examination Auditor

1 week ago


Southfield, United States MEDLOGIX, LLC Full time
Job Overview

Position Title: Claims Quality Assurance Reviewer
Company: MEDLOGIX, LLC
Location: Hybrid (Remote and in-office collaboration)

About MEDLOGIX: We specialize in delivering advanced medical claims solutions through a combination of innovative technology, skilled professionals, and extensive healthcare provider networks. Our commitment to excellence ensures that client needs are prioritized, resulting in a streamlined insurance claims process that enhances productivity and reduces costs for various stakeholders, including auto insurance and workers' compensation carriers.

Key Responsibilities:

  • Conduct thorough quality assurance evaluations of independent medical examination reports, peer review documents, and related correspondence.
  • Ensure that all recommendations and determinations are supported by clear, evidence-based rationales.
  • Verify adherence to client specifications and address all inquiries comprehensively.
  • Maintain the highest standards of content, format, and professionalism in all reports.
  • Identify and rectify any discrepancies within the documentation.
  • Foster effective communication with medical professionals and legal representatives to ensure timely report delivery.
  • Assist in resolving client concerns and quality assurance challenges as necessary.
  • Stay proficient with company software and databases.

Qualifications:

  • Preferred: College degree or equivalent experience in claims adjusting.
  • Strong organizational, problem-solving, and time management skills with the ability to work autonomously.
  • Exceptional communication skills, including the ability to convey information accurately and listen attentively.
  • Commitment to confidentiality and a positive team-oriented approach.
  • Ability to maintain focus and productivity in a dynamic environment.
  • Capacity to handle pressure and adapt to changes or unexpected situations.
  • Reliability and adherence to company attendance policies.
  • Proficiency in Microsoft Office applications is essential.
  • Familiarity with claims and medical terminology, particularly in No Fault, Workers Compensation, or Liability contexts, is advantageous.
  • Experience in reviewing IME and Peer Review reports is preferred.

Diversity and Inclusion: MEDLOGIX is an equal opportunity employer, committed to fostering a diverse and inclusive workplace. We prohibit discrimination and harassment of any kind and uphold equal employment opportunities for all individuals.



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