Case reviewer vs service assistant

Differences between case reviewer and service assistant duties and responsibilities

Case reviewer example responsibilities.

• Manage afive person team responsible for covering scope, assigning, analysis and then final review ofInvestigation ROI.
• Require a broad and comprehensive knowledge of Medicaid policies, code references, and compliance.
• Provide education to physicians/office staff on aspects of HEDIS medical record documentation, compliance, and regulatory criteria.
• Participate in meetings with inter agencies and other entities as appropriate to facilitate and enhance the Medicaid eligibility determination process.
• Communicate regularly with client and travele frequently to arbitration site.
• Assist in preparation of witnesses and exhibits for depositions and arbitration hearings.
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Service assistant example responsibilities.

• Manage day-to-day operations including contract management, accounts payable, receivables, payroll and general administrative assistance.
• Develop contracting strategy to build capacity and achieve ongoing compliance with Medicare and Medicaid provider network adequacy requirements.
• Manage and update company Facebook page with daily updates, finding/sharing relevant and interesting information, and encouraging fan engagement.
• Function as part of the trauma team by performing CPR.
• Set up and maintain CPR certifications for all instructional aids.
• Review supplies, materials, vendor selection for WIS and NICU.
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