ExamWorks

Quality Review Specialist (Editor) (31423)

ExamWorks  •  $34/hr  •  Vaughan, CA (Onsite)  •  4 months ago
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Job Description

Job Location: Vaughan, ON L4K 0C5
Position Type: Full Time
Salary Range: $24.50 - $34.00 Hourly

Travel Percentage: NoneSOMA is looking for a full-time Quality Review Specialist (Editor)!
The Quality Review Specialist (Editor) is responsible for reviewing submitted reports to ensure the quality expectations of our customers and company-specific guidelines are met. This position will work closely with the individual assessors to advise and ensure the necessary report requirements are met.
ESSENTIAL JOB FUNCTIONS
- Review reports in the system against quality and compliance guidelines to ensure the report meets the minimum requirements.
- Maintain strict deadlines by reading a minimum of 6-8 reports per shift.
- Effectively communicate with assessor regarding any revision requirements or quality concerns.
- Participate in company orientations, management meetings and/or conference calls as required.
- Aid in identifying industry trends.
- Proficient in working in customer’s claims systems to enter data or complete required quality staffing or audits.
- Provide insight and direction to management on report quality and compliance with all company-specific policies and procedures and client specifications.
- Promote effective and efficient utilization of company resources.
- Participate in various educational and or training activities as required.
- Perform other duties as assigned.

QualificationsEducation and/or Experience
- Associates Degree required, Bachelor’s Degree preferred.
- Must be a graduate of a national accredited nursing program with a minimum of five years workers’ compensation rehabilitation and/or case management experience required.
QUALIFICATIONS
- Must have knowledge of the disability and workers' compensation industry including rules and regulations and an understanding of clinical procedures and all processes involved in the delivery of quality health care to an injured worker.
- Must be able to adequately operate a general computer, fax, copier, scanner, and telephone.
- Must have strong knowledge of multiple software programs, including but not limited to Microsoft Word, Outlook, Outlook Web Access, Excel, and the Internet.
- Must have knowledge of current laws and regulations that govern delivery of rehabilitation services.
- Must have knowledge of human behavior and performance.
- Ability to demonstrate strong customer service knowledge including needs assessment, meeting quality standards for services and evaluation of customer satisfaction.
- Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed.
- Must be able to work independently, prioritize work activities and use time efficiently.
- Ability to concentrate and multitask in a fast paced work environment.
- 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 maintain confidentiality.
- Must be able to demonstrate and promote a positive team-oriented environment.
- Must be able to work well under pressure and/or stressful conditions.
- Must possess the ability to manage change, delays, or unexpected events appropriately.
- Must possess excellent skills in English usage, grammar, punctuation and style.
- Ability to follow all company policies and procedures in effect at time of hire and as they may change or be added from time to time.
ABOUT US:
SOMA provides independent medical evaluation and related services to property and casualty insurers, group disability insurers, employers, law firms, and government agencies. Clients utilize our services to facilitate fair and equitable claims settlements and enhance their risk mitigation processes.  Our services are available throughout Canada and internationally in the U.S., the United Kingdom, and Australia. Regulatory compliance and oversight authenticated by independent third-party auditors assures clients of the integrity of our process controls.
SOMA  is an Equal Opportunity Employer and affords equal opportunity to all qualified applicants for all positions without regard to protected veteran status, qualified individuals with disabilities and all individuals without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, age or any other status protected under provincial or federal laws.
ExamWorks

About ExamWorks

The ExamWorks Group platform, family company services, applications and portals for the management of independent medical claim review are the assets of choice among claims professionals. Our global service network and private cloud-based computing platform connects medical professionals, case managers, and claimants to property, casualty, and disability insurers, third-party administrators, and legal professionals so they can provide evidence-based independent expert medical opinions and analysis for claims resolution. Secure, streamlined, automated, customized, independently audited and accredited workflows assist clients to manage costs by verifying the validity, nature, cause, and extent of claims, identifying fraud and providing fast, efficient and quality IME services.

Industry
Finance & Insurance
Company Size
501-1,000 employees
Headquarters
Atlanta, GA
Year Founded
2008
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