STG International is currently seeking a Case Review Specialist for Federal Occupational Health Services in Rockville, MD.
Job Specific Duties and Responsibilities:
Provide direct support to the mission of Federal Occupational Health (FOH), a component of the Program Support Center (PSC), to improve the health, safety, and productivity of the Federal workforce by performing fulfillment of case review activities (review of service and provider fulfillment), interacting with internal and external customers regarding questions and clarification of services or other communication essential to the maintenance of the agreement and coordinating service delivery with FOH Business Operations team. Serves as Case Review Specialist for the case review process to include ensuring exam scheduling, appropriate management and processing of all medical records, Quality Assurance (QA) is completed on exams according to the Interagency Agreement (IAA) and the Case Review Processing Order, complete exams are sent to the RMO for review, timely and secure transmission of the Reviewing Medical Officer (RMO) determinations to the customer agency and their employees (as applicable). Enter charges for exams and administrative fees to cost recover.
Other duties may include outreach to clinics to retrieve missing exam items, work with Occupational Health Clinics (OHC) to ensure all portions of exam completed are billed for appropriately, collaborate with FOH team members to ensure workflow facilitates the customer needs are met, relay any concerns raised by customers to Program Manager (PM).
Quality and Safety
Service Operations
Procurement
Cost Recovery
Staffing and Reporting Relationships
Technology
Customer Service
STG International, Inc (STGi) is a workforce solutions company providing comprehensive healthcare delivery, Head Start and management consulting services and human capital solutions help our clients. Our services and solutions help our clients sustain and enhance their operations to better accomplish their mission.
STGi offers a competitive benefits package which includes Medical, Dental, Vision, 401k with company match and a generous PTO policy.
STG International, Inc. is committed to hiring and retaining a diverse workforce. We are proud to be an Equal Opportunity/Affirmative Action Employer, making decisions without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other protected class.