Position Overview:
The Quality Control Specialist for Medical Reports plays a crucial role in ensuring the accuracy, completeness, and quality of medical reports submitted for insurance purposes. This role involves reviewing and analyzing medical documents, verifying information, and ensuring adherence to established guidelines and regulatory requirements. The Quality Control Specialist works closely with healthcare professionals, insurance companies, and internal teams to maintain high standards of accuracy and consistency in medical reports.
Key Responsibilities:
ew Medical Reports: Thoroughly examine medical reports, including customer / patient histories, diagnoses, treatment plans, and other relevant information, to ensure accuracy, completeness, and compliance with industry standards and insurance guidelines.
fication of Information: Cross-check all information provided in the medical reports, such as patient demographics, dates, procedures, medications, and test results, to ensure consistency and accuracy.
liance Monitoring: Ensure compliance with applicable regulations, such as HIPAA (Health Insurance Portability and Accountability Act) and other privacy laws, as well as insurance policies and guidelines.
ity Assurance: Identify and rectify errors, inconsistencies, or missing information in medical reports by collaborating with healthcare professionals, insurance providers, and other stakeholders.
mentation and Reporting: Maintain detailed documentation of quality control activities, including identified issues, corrective actions taken, and overall performance metrics. Generate reports on quality control findings and trends, and communicate them to relevant stakeholders.
ess Improvement: Identify opportunities for process improvement, such as streamlining workflows, enhancing data collection methods, and implementing automated quality control tools to enhance efficiency and accuracy.
1 - 3 Years
5 Openings
Not Disclosed
Face-to-Face interview
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