Case Coordinator

• Perform quality assurance reviews of reports, correspondence, addendums, and supplemental reviews
• Ensure clear, concise, evidence-based rationales support recommendations and determinations
• Verify client instructions, specifications, and questions are addressed
• Confirm clinical citations and references are current and from reputable medical journals or publications
• Ensure report content, format, and professional appearance meet company standards
• Verify appropriate board specialty review and accurate documentation on case reports
• Verify peer reviewer attestations and absence of conflicts of interest
• Ensure provider credentials and signatures are included in final reports
• Identify report inconsistencies and contact Peer Reviewers for clarification or correction
• Assist with customer complaints and quality assurance issues
• Ensure compliance with federal ERISA and state mandates
• Provide management insight on consultant quality, availability, and compliance
• Promote effective utilization of company resources
• Participate in educational and training activities
• Perform other assigned duties

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