About The Company
Healthcare Quality Strategies, Inc. (HQSI) is a leading organization dedicated to providing high-quality medical review services to healthcare payers, providers, and other stakeholders. With a focus on accuracy, efficiency, and compliance, HQSI strives to enhance the integrity of healthcare decision-making processes through comprehensive case assessments and expert evaluations. The company is committed to fostering a diverse, inclusive, and supportive work environment, offering employees opportunities for growth and development within the healthcare sector. HQSI values innovation, integrity, and excellence, ensuring that all services adhere to the highest standards of confidentiality and regulatory compliance.
About The Role
The Medical Review Support Specialist is a vital role within HQSI’s Medical Review Services department, responsible for managing administrative functions related to case intake, conversion, assignment, review, and completion. This position supports the seamless flow of case management operations by ensuring accurate documentation, timely case processing, and effective communication with internal and external stakeholders. The role involves working remotely from home, with potential requirements for on-site presence in the future based on organizational needs. The ideal candidate will be detail-oriented, highly organized, and capable of managing multiple tasks efficiently in a fast-paced healthcare environment. This position offers a salaried, non-exempt status with an annual compensation of $55,000 and a standard 40-hour workweek.
Qualifications
Healthcare Quality Strategies, Inc. is an Equal Opportunity Employer. We are committed to creating a diverse and inclusive workplace and do not discriminate against any applicant or employee based on race, color, religion, sex, national origin, disability, age, sexual orientation, gender identity, or any other protected characteristic. We promote equal employment opportunities and encourage candidates from all backgrounds to apply. All employment decisions are made based on qualifications, merit, and organizational needs. We also provide reasonable accommodations to qualified individuals with disabilities to ensure equal access to employment opportunities.
Healthcare Quality Strategies, Inc. (HQSI) is a leading organization dedicated to providing high-quality medical review services to healthcare payers, providers, and other stakeholders. With a focus on accuracy, efficiency, and compliance, HQSI strives to enhance the integrity of healthcare decision-making processes through comprehensive case assessments and expert evaluations. The company is committed to fostering a diverse, inclusive, and supportive work environment, offering employees opportunities for growth and development within the healthcare sector. HQSI values innovation, integrity, and excellence, ensuring that all services adhere to the highest standards of confidentiality and regulatory compliance.
About The Role
The Medical Review Support Specialist is a vital role within HQSI’s Medical Review Services department, responsible for managing administrative functions related to case intake, conversion, assignment, review, and completion. This position supports the seamless flow of case management operations by ensuring accurate documentation, timely case processing, and effective communication with internal and external stakeholders. The role involves working remotely from home, with potential requirements for on-site presence in the future based on organizational needs. The ideal candidate will be detail-oriented, highly organized, and capable of managing multiple tasks efficiently in a fast-paced healthcare environment. This position offers a salaried, non-exempt status with an annual compensation of $55,000 and a standard 40-hour workweek.
Qualifications
- Minimum high school diploma or GED; some college or vocational training preferred
- At least 3 years of experience in a healthcare office setting, such as health insurance, physician’s office, hospital, or outpatient environment
- Proficiency in Microsoft Office Suite (Word, Excel, Outlook, Adobe) and familiarity with project and document management software
- Knowledge of medical terminology and healthcare compliance standards, including HIPAA/HITECH
- Strong organizational and calendar management skills
- Effective written and verbal communication abilities
- Experience in customer service, both internal and external
- Ability to perform multiple tasks, meet deadlines, and work independently in a remote setting
- Basic physical ability to operate office equipment and communicate effectively
- Scan and log incoming paper charts, extract and transfer electronic charts, and ensure proper documentation
- Manage case intake and conversion within the document management system, assessing documentation requirements and preparing cases for review
- Assign cases to Non-Physician Reviewers (NPRs), Physician Reviewers (PRs), and allied healthcare professionals
- Monitor task due dates and ensure timely completion of review assignments
- Draft final determination letters and proofread formatting before submission for final review
- Track receipt and completion of Conflict of Interest statements from reviewers
- Generate and evaluate reports to manage workflow, resource allocation, and case volumes
- Assist with credentialing activities and physician recruitment outreach as needed
- Monitor multiple contract mailboxes and handle correspondence efficiently
- Support documentation and administrative activities to facilitate smooth case processing
- Medical, Dental, and Vision insurance coverage
- Flexible Spending Account (FSA) and Health Savings Account (HSA)
- Group Life and AD&D insurance, voluntary life/AD&D options
- 401(k) retirement plan with company matching
- Opportunities for remote work and flexible scheduling
- Professional development and training programs
- Supportive and inclusive work environment
Healthcare Quality Strategies, Inc. is an Equal Opportunity Employer. We are committed to creating a diverse and inclusive workplace and do not discriminate against any applicant or employee based on race, color, religion, sex, national origin, disability, age, sexual orientation, gender identity, or any other protected characteristic. We promote equal employment opportunities and encourage candidates from all backgrounds to apply. All employment decisions are made based on qualifications, merit, and organizational needs. We also provide reasonable accommodations to qualified individuals with disabilities to ensure equal access to employment opportunities.