Job Description
Job DescriptionWorking with assessors, the QA Editor will ensure the final product (the medical report) is released with utmost accuracy and on time.Education and ExperienceMinimum 2 years of experience in medical editing or prior experience working in a hospital or clinic settingUniversity/college degree (medical designation preferred)Solid working knowledge of PIPEDA/PHIPA and best practicesKnowledge 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 experienceMust possess strong tendencies for accuracy and attention to detailDemonstrated ability to promote a positive team-oriented environment Demonstrated ability to work well under pressureExtensive knowledge of medical terminology and medical disciplinesDemonstrated 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 initiativeStrong 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 mannerCatastrophic claims and AMA Guides experience also considered an asset;Relevant experience in IME work is an assetEssential 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 LegislationConverse with customers as requiredConstructing 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 accuratelyGenerating 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 standardsResponsible 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 informationLiaise 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 weekJob Type: Full-timePay: $38,000.00-$48,000.00 per yearBenefits:Casual dressDental careExtended health careOn-site parkingPaid time offWork from homeSchedule:8 hour shiftMonday to FridayNo weekendsSupplemental pay types:Bonus payOvertime payWork Location: Hybrid remote in Toronto, ON