Review Coordinator Job Description
Review coordinator
provides expertise for the revision of Health Plan Credentialing Bylaws and Credentialing Plan, manuals, rules and regulations for credentialing.
Review Coordinator Duties & Responsibilities
To write an effective review coordinator job description, begin by listing detailed duties, responsibilities and expectations. We have included review coordinator job description templates that you can modify and use.
Sample responsibilities for this position include:
Coordinator / liaison within the COO team involved in major production components each function, including Risk, Projects, Reporting and Administrative
Support divisional and Finance COO agenda Firmwide strategic initiatives on behalf of VRG
Serve as the subject-matter-expert and lead tester / coordinator for all systems related to Projects & Budgeting, Risk, resources and other Mark Review reporting applications
Assist with the divisional operating model and location strategy responsibilities
Support the VRG Risk space with RCSA, Operational Risk Incidents, Audit items, and other regulatory requests
Assist with Finance initiative budgeting process, resource management, project management, and prioritization within the Projects function
Facilitate and organize scheduling of reporting deadlines required for daily, weekly, monthly and quarterly Mark Reviews, fair value disclosures and additional ad-hoc requests
Produce resourcing updates, expense reports, activity-based costing deliverables, organizational charts, and metrics / analytics for Finance and VRG senior management
Maintain membership rosters, correspondence and records, monitoring committee membership, monitoring conflicts of interest, and monitoring reassignments of reviewers via the Grant@Heart system
Monitors grant budgetary information and contributed services from assigned peer review committees by verifying figures, auditing for authorized expenditures, and inputting results into Grants@Heart
Review Coordinator Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Review Coordinator
List any licenses or certifications required by the position: CM, BLS, MA, TCM, BEP/WBE/MBE, NEMT, CCM, CPR, MCHES, CHES
Education for Review Coordinator
Typically a job would require a certain level of education.
Employers hiring for the review coordinator job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Master's Degree in Nursing, Education, Social Work, Health, Associates, Management, Psychology, Medical, Health Care, Human Services
Skills for Review Coordinator
Desired skills for review coordinator include:
Diagnostic codes
Medical contracts
Medical terminology
CMS regulations and health plan partner policies
Various health plan partner benefits
Networks
CGMP’s
CMDRs
EMEA regulations
ICD9 and CPT coding
Desired experience for review coordinator includes:
Experience working in a Finance division
Current Florida R.N., L.P.N., or Licensed Clinical Social Worker license
R.N., L.P.N., M.S.W., or undergraduate degree in the Healthcare
Two years’ experience in utilization review and discharge planning preferred
Knowledge of managed care case management functions
Active participation in professional groups to keep updated on changes in regulations
Review Coordinator Examples
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Review Coordinator Job Description
Job Description Example
Our company is looking for a review coordinator. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for review coordinator
- Must be able to demonstrate excellent written and oral communication skills and the ability to work with all career stages and levels of individuals
- Strategic planning skills will be used to generate meaningful opportunities for stakeholders so they can utilize their passion to further the mission of the organization
- Works collaboratively with Patient Access Staff and Insurance Verification Staff to assure the accurate payer and demographic information is documented in the I.T
- Communication with appraisers as applicable to facilitate order fulfillment
- Communicating with reviewers, vendors, and internal business
- Updating CMS with adequate notes to document appraisal status
- Problem resolution of escalated appraisal issues
- CMS/JC Core Measures reviews
- Other quality initiatives, CHOIS complication & mortality review, NCDR - Get with the Guidelines, Mission Lifeline, STS
- Analyzes and reports data from clinical outcomes systems such as CHOIS, Core Measures
Qualifications for review coordinator
- One year Healthcare related field experience
- Minimum of five (5) years related experience with an understanding of Scientific Process and Peer Review
- Must have the ability to simultaneously manage multiple, complex projects in varying stages of development while under time constraints
- BLS & Driver License required
- Prefer bilingual, experience in Pediatrics, and worked with underserved populations
- ED/ICU/PCC experience preferred
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Review Coordinator Job Description
Job Description Example
Our innovative and growing company is looking to fill the role of review coordinator. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for review coordinator
- Support the care of the patient through assessment, planning, implementation and evaluation of appropriate services and resources to maximize optimum outcomes
- Work collaboratively with the multiple disciplines, both internal and external to the organization, in effecting quality and cost-effective management of the patient's care along the continuum
- Contact insurance carrier after verifying information to secure benefit coverage, policy limitations, and pre-certification for patients
- Conduct follow-up calls necessary to physician offices and third party payor to complete pre-certification process
- Assist and cooperate in communicating and corresponding with patient compliance as needed
- Document and process financial and pre-certification request for patient referral
- Verify billing information from providers
- Enter authorizations in system
- Responsible for pre-admission and concurrent reviews for admissions and continued placement in Medicaid certified nursing facilities, utilizing federal and State’s criteria
- Schedules and conducts document-based quality reviews that adhere to state-directed clinical criteria for determining medical need
Qualifications for review coordinator
- Must be able to type 25 words per minute (will be tested)
- Experience with medical billing, insurance and patient contact strongly preferred
- 3-5 years in a high volume administrative role working on and resolving complex tasks or the equivalent of a Bachelor's degree and 1-3 years work experience
- Basic computer skills, MS Office applications (Word, Excel and Access) preferred
- Ability to work independently, multi-task, and prioritize a daily workload to meet department deadlines
- Prior experience with residential valuation products (Appraisals, AVM, Desktops)
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Review Coordinator Job Description
Job Description Example
Our innovative and growing company is looking to fill the role of review coordinator. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for review coordinator
- Is able to use the Loan Originations systems, as needed
- Maintains expertise on critical lending regulatory guidelines and internal and external auditing
- Advise patient/primary therapist of any adverse determination within 24 hours
- Keeps current with governing and guiding documents and publications for the protection of human subjects, including the Code of Federal Regulations (45 CFR 46), Guidance from Office of Human Research Protections (OHRP), and regulations generally referred to as the Revised Common Rule
- Maintains resources for information and education regarding IRB issues
- Holds current Collaborative Institutional Training Initiative (CITI) training for protection of human subjects, or will complete this training upon employment
- Attends a Public Responsibility in Medicine and Research (PRIM&R) or similar conference at least annually as budget allows
- Coordinates all IRB applications through the IRBManager online portal and assists faculty, staff, and students in the submission process with substantive and technical questions by phone, email, and in person as needed
- Acts as a liaison between IRB members and researchers to assure compliance with regulatory and institutional requirements in the application and renewal procedures
- Screens submissions for the proper level of review
Qualifications for review coordinator
- Prior experience preferred with CMS and ACAPS systems
- High school Diploma or equivalent Required BS/BA preferred
- Knowledge of health care service delivery systems and third party reimbursement understanding of admission/discharge function
- Successful completion of Crisis Prevention Intervention (CPI) within 90 days of employment
- Prefer telephone call center and/or medical office experience
- Good telephone etiquette and customer service orientation
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Review Coordinator Job Description
Job Description Example
Our company is searching for experienced candidates for the position of review coordinator. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for review coordinator
- Prepares IRB meeting agendas and completes minutes using the IRBManager system
- Meets with the IRB Chair and Executive Director of Research and Grants and RIO regularly to discuss research situations and topics that need immediate attention
- Researches information from NIH, OHRP, and other regulatory bodies best practices from other institutions regarding topics of interest and areas of challenge in the protection of human subjects in research
- Gathers information for the education portion of the IRB meeting
- Communicates with the IRB members prior to monthly meetings to guarantee a quorum and notifies alternates as needed
- Arranges meeting room, hospitality services, and technical services for IRB meetings
- Manages the IRB budget and reports to the Executive Director of the Office of Research and Grants accordingly
- Attends meetings of the IRB to facilitate the meeting, assist the chair, and take minutes
- Invites those researchers whose applications will be considered by the full board to be available at the monthly meeting as requested by the reviewers
- Maintains records of correspondence with applicants per federal guidelines
Qualifications for review coordinator
- Knowledge of Microsoft Word and Excel and ability to learn new software applications
- Ability to manage time effectively, set priorities, accommodate multiple demands for time and resources
- Demonstrated knowledge of quality assessment and improvement throughout the continuum of patient care
- Strong problem solving, project management, teamwork, written, and oral communication skills
- Knowledge of accreditation and licensing, including The Joint Commission, NCQA, and Title 22 standards/regulations
- Bachelor’s degree preferred, preferably in a health-related field
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Review Coordinator Job Description
Job Description Example
Our company is searching for experienced candidates for the position of review coordinator. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for review coordinator
- Assists the Research Integrity officer (RIO) in submitting and maintaining required federal data
- Ensures all applicants and those who review applications have current CITI certification
- Assists in the appointment of IRB members as needed, ensuring that potential and new members are provided with necessary information and orientation related to IRB membership
- Alerts the IRB Chair and RIO to adverse events during research, and participates in the discussion, action, and resolution as requested
- Coordinates through the IRBManager online portal all renewal and revision applications from projects still holding current approval and closure reports from applicants whose approval has expired
- Maintains a database for Potential Conflict of Interest Disclosure forms received by applicants to the Institutional Review Board and the applicants for external grants and assists the Committee on the Conflict of Interest as necessary when they review cases
- Provides concurrent review of patient care for the purpose of resource monitoring, allocation and coordination of continuing care
- Works toward improving division performance standards for identified HEDIS measurements which are to be selected and defined by Physicians Services Group (PSG) and Director of Quality
- Coordinates with practice and providers in communication to patients to resolve clinical gaps related to medication adherence, medication safety instructions, preventive care based on evidence based guidelines and other patient identifiers
- Helps prepare, develop, promote and monitor processes for improvement performance in patient care and health maintenance based on evidence based guidelines
Qualifications for review coordinator
- Minimum of 2 years’ experience in a regulated medical device, biotech, or pharmaceutical environment, with quality experience preferred
- Knowledgeable in quality improvement principles and the application of quality improvement tools and techniques
- ASQ Certification desirable but not required
- Knowledge of ISO 13485 and 21 CFR 820 preferred
- Effective document review skills and understanding of GMP requirements
- Ability to establish collaborative working relationships in a matrix organization internally with a diverse / global supply base