Quality Assurance

2 weeks ago

Toronto, Canada Assessment Rehabilitation Services Ltd. Full time

**Position**:QA Medical Editor

**Reporting to**: Quality Assurance Supervisor

Working with assessors, the QA Editor - Catastrophic Assessments will ensure the final product (the medical report) is released with utmost accuracy and on time.

**Education and Experience**

Minimum 2 years of experience in medical editing or prior experience working in a hospital or clinic setting

University/college degree (medical designation preferred)

Solid working knowledge of PIPEDA/PHIPA and best practices

Knowledge of relevant legislation as it relates to key customers (e.g. knowledge of the Statutory Accident Benefits Schedule (SABS)

Strong communication skills, both written and verbal. Demonstrated ability to type a minimum of 50 W.P.M.

Highly organized, results-oriented, independent problem solver with demonstrated clinical, medical legal assessment and/or adjudication experience

Must possess strong tendencies for accuracy and attention to detail

Demonstrated ability to promote a positive team-oriented environment
Demonstrated ability to work well under pressure

Extensive knowledge of medical terminology and medical disciplines

Demonstrated ability to work independently, prioritize work activities and manage time efficiently. Ability to work in a fast paced and high stress environment along with ability to multi-task, time manage and prioritize on own initiative

Strong problem solving, decision making, critical thinking, and multitasking skills.

Proficiency in Microsoft Outlook, Word, Excel, Internet Explorer etc. is necessary to carry out all job duties in a comprehensible and efficient manner

Catastrophic claims and AMA Guides experience is required.

Relevant experience in IME work is required

**Essential Duties and Responsibilities Include, but are not limited to the following**:
Read through reports and medical documentation, to identify omissions, errors and inconsistencies.

Review reports on mutli-disciplinary files to ensure consensus has been met. This would include spelling errors, confirming consistency, placing information in incorrect fields, and adding other information as pertaining to the medical document;
Conduct research, as required, to ensure ongoing understanding of current SABS Legislation

Converse with customers as required

Constructing and cross-referencing medical documents and checking WPI calculation according to the AMA guidelines;
Preparing medical summaries from the medical documents of the claimants;
Ensuring a high level of customer service and maximizing productivity by processing claims accurately

Generating necessary notification letters to parties as specified by client;
Analyzing information in an environment where communications are complex and often fast-paced.

Research and review processed claims for necessary adjustments or corrections, identifying errors in claims submitted by medical professionals.

Maintaining documentation of all correspondence and contact with carrier, claimant, physician, attorneys, etc. to ensure a comprehensive and detailed source of information regarding the case;
Consistently meet established productivity, schedule adherence, and quality standards

Responsible for investigating and making recommendations for the resolutions of errors in IME from medical professionals.

Follow up phone calls to medical professionals to gather extended information

Liaise between sales staff and management;
Keeping updated on laws and regulations relating to all lines of insurance;
Other job duties as required.

**Job Type**: Full-time, 37.5 hours a week

**Salary**: $40,000.00-$500,000.00 per year

**Benefits**:

- Casual dress
- Dental care
- Extended health care
- On-site parking
- Paid time off
- Work from home

Schedule:

- 8 hour shift
- Monday to Friday
- No weekends

Supplemental pay types:

- Bonus pay
- Overtime pay

Work Location: Hybrid remote in Toronto, ON

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