The Review Specialist II is responsible for scheduling regular client requests and provides documentation of such requests. The incumbent will communicate any changes, updates or issues to Lead Review Specialist, Sr. Lead Review Specialist or Operations Manager.
Process, track and monitor client requests across all aspects of Employer’s offered services for a) onsite credentialing reviews (if applicable), b) corrective action solutions, c) HEDIS chart abstractions, d) Medicare risk adjustment reviews and e) custom chart abstractions
Schedule 1.25 regular pick list on-site reviews (per regular scheduling hour) for the Site Review Consultants or other field review staff in an organized and efficient manner following Inovalon’s documented procedure for scheduling, documenting the contact and sending the required documentation to the scheduled facility
Serve as the daily communication coordinator for any assigned Site Review Consultants (SRCs) or other field review staff
Identify opportunities for system and operational quality improvement
Provide administrative support to management including, but not limited to, scheduling and staffing meetings, organizing and producing documents, maintaining filing systems, mailings and other daily tasks incidental to operations
Ability to perform all duties of a Review Specialist
Maintain compliance with Inovalon’s policies, procedures and mission statement
Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon’s Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position
Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the Company.
6-12 months as a Review Specialist preferred – depending on location and business needs.
Strong communication skills
Strong sales skills
Ability to coordinate site and reviewer schedules
Strong negotiation skills
Time management and multi-tasking capabilities
High School Diploma or equivalent experience