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Medical Reports Coordinator

2 weeks ago

Markham, Canada Direct IME ON Full time

Overview:
**Direct IME** is seeking a
**Medical Reports Proofreader** (internally known as Quality Assurance Coordinator).

This position is a hybrid role with a standard
**Monday to Friday schedule**.

The Quality Assurance Coordinator is responsible to ensure reports are of the highest quality and integrity and in full compliance with client contractual agreement, regulatory agency standards and/or federal and provincial mandates.

**Medical Reports Proofreaders come from various backgrounds including, those studying kinesiology, chiropractic, exercise medicine, and registered massage therapy.**

Direct IME offers a comprehensive benefits package.

**Responsibilities**:
**RESPONSIBILITIES**:

- Review of Catastrophic and complex reports
- Review reports to assure no grammatical, typographical or compositional errors
- Performs quality assurance review of reports, correspondences, addendums or supplemental reviews in the context of the file documents to ensure accuracy of examinee name, claim number, all identifying information, and context of the referral (any questions posed by the client) with full compliance to Legislative policies (if applicable)
- Follow up with assessors to ensure edits are completed and in the case of Multi-Disciplinary evaluations, facilitate delivery and review of all reports involved in the evaluation process.
- Ensures clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations.
- Ensures that all client instructions and specifications have been followed and that all questions have been addressed.
- Ensures each review is supported by clinical citations and references when applicable and verifies that all references cited are current and obtained from reputable medical journals and/or publications.
- Ensures the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards.
- Ensures the provider credentials and signature are adhered to the final report.
- Identifies any inconsistencies within the report and contacts the assessor to obtain clarification, modification or correction as needed.
- Assists in resolution of customer complaints and quality assurance issues as needed.
- Provides insight and direction to management on consultant quality, availability and compliance with all company policies and procedures and client specifications.
- Communicate efficiently and effectively with adjusters/clients over the phone and through written correspondence.
- Resolve any questions or concerns raised either internally or externally (clients) in a timely and professional manner for assigned cases
- Participate in various educational and or training activities as required.
- Act as a resource for Intake and Med docs department to ensure correct assessments/addendums are scheduled, appropriate documents sent to assessors, etc.
- Perform other duties as assigned.

Qualifications:
**QUALIFICATIONS**:

- Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values.
- Familiarity and experience with insurance claims and legislative policies and medical terminology in order to read and critically analyze reports and communicate intelligently with physicians and clients is mandatory.
- Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed.
- Proficiency in Microsoft Outlook, Word, Excel, Internet etc. is necessary to carry out all job duties in a comprehensible and efficient manner. Must possess strong tendencies for accuracy and attention to detail.
- Ability to work in a fast paced and high stress environment along with ability to multi-task, time manage and prioritize on own initiative.
- Ability to work as part of a team.
- Fluent command of the English language, written and oral.
- Post-Secondary education is an asset.
- Regulated Health Professional is an asset.
- Relevant experience in IME work is an asset.
- Demonstrates accuracy and thoroughness. Looks for ways to improve and promote quality and monitors own work to ensure quality is met.
- Must be able to work independently, prioritize work activities and use time efficiently.
- Must be able to maintain confidentiality.
- Must be able to demonstrate and promote a positive team -oriented environment.
- Must be able to stay focused and concentrate under normal or heavy distractions.
- Must be able to work well under pressure and or stressful conditions.
- Must possess the ability to manage change, delays, or unexpected events appropriately.
- Demonstrates reliability and abides by the company attendance policy.
- Must maintain a professional and clean appearance at all times consistent with company standards.

**ABOUT US**:
**Direct IME** provides independent medical evaluation and related services to property and casualty insurers, group disability