What are the responsibilities and job description for the Medical Case Reviewer position at NMS Health?
As an alternative to direct patient care, NMS Health offers an energetic and team-focused work environment that offers the ability to utilize your occupational health skills and knowledge without the typical on-your-feet clinical/hospital grind.
Company Overview:
NMS Health, an administrator of occupational health services, is seeking a candidate who can provide exceptional service to our FFD Clients, primarily in maritime and government agency settings. NMS specializes in providing comprehensive medical surveillance that aims to provide the healthiest and most physically qualified employees for our clients. Since 1994, NMS has been providing occupational health services across all major industries including pharmaceutical, tourism, chemical, maritime and more!
Position Overview:
The Medical Case Reviewer will ensure timely and accurate medical review and the completion of medical clearances in accordance with company standards and processes.
Works in partnership with NMS Health's Medical Advisor, reporting to the Portfolio Manager, to ensure medical exams are reviewed and completed to establish fit or unfit status for client employees.
Works directly with vendor clinic partners, specifically medical providers, to ensure fit for duty exams are administered and completed correctly as per client protocols.
Medical Case Review Responsibilities
- Making informed decisions based on complete and thorough review of medical records, labs, and other pertinent supporting documentation required to issue clearance for clients and/or make recommendations to appropriate NMS Health team members.
- Follow state and federal regulations as well as internal policies and guidelines while analyzing medical records.
- Communicate with providers and staff to clarify findings and/or information and will collaborate and educate current staff providers around insights derived from patient medical records, patient interviews, research, and consult from the Portfolio Manager.
- Works with providers to ensure clinical documentation accurately reflects findings.
- Works to assess medical documentation with the intent of identifying and compiling findings which inform a clinically backed focus of care for NMS Health’s client’s candidates & employees.
- Ensures records are accurate and properly supported by clinical documentation within the health record and enters all necessary information into NMS Health’s system of records to ensure continuity.
- Identifies opportunities to improve provider documentation and process with actionable plans for improvement to present to the Portfolio Manager.
Special Review Responsibilities
- Identify and act accordingly on potential medical issues that may pose a risk to the individual or others in their working environment
- Provide clear directions via written and verbal communication regarding medical findings and recommendations on next steps to candidates and out of network providers as necessary
- Communicate as needed with candidate/employee’s personal care providers or specialists regarding letters, testing or guidelines for medical clearance
- Continue to follow up with the individual until there is a resolution and final fit for duty status is determined
Preferred Core Qualifications:
- Experience in occupational health
- Clinical Medical Assistant or Registered/Licensed Practical Nurse
- Strong knowledge of medical conditions and treatment, medications, laboratory testing, and vaccination schedules.
- Proficient in managing electronic documents and systems. Familiarity with the Microsoft Office Suite, Adobe Acrobat and other document management tools
- Strong electronic organizational skills
- Familiarity with cloud storage software
- Experience in dealing with medical records in a HIPAA compliant environment
- Positive and friendly phone manner
- Experience with telephone triage is a plus
- Ability to work and perform on heavy deadline driven tasks daily
- Grit/perseverance and commitment
- Customer service experience
Additional Compensation:
- Performance Bonuses Available
Benefits:
- ICHRA (health insurance reimbursement)
- Retirement plan (401K)
- Paid time off
- Employee discounts
- Equipment loan
Schedule:
- Monday-Friday
- 30 Hours per week