Clinical Proofreader Editor

A remote Clinical Proofreader/Editor role focused on ensuring compliance, accuracy, and quality in member and provider correspondence within the healthcare industry. The position involves reviewing clinical system events, collaborating with internal teams, and adhering to regulatory standards.

Location: Remote

Salary: Starting at $25+/HR

Responsibilities

• Complete assigned correspondence tasks promptly and within designated timeframes.
• Identify gaps in processes and provide actionable feedback to reduce errors and improve overall quality.
• Review member and provider communications to ensure consistency with the clinical system (TruCare) and compliance with regulatory guidelines.
• Audit and analyze correspondence to confirm accuracy with TruCare records and ensure the appropriate templates are utilized correctly.
• Work closely with care managers, leadership, and peer reviewers to maintain compliance with regulatory-mandated communications.
• Assess correspondence for accurate medical terminology and adherence to departmental policies and applicable regulations.
• Support the organization in managing the lifecycle of correspondence, including creation, storage, secure retrieval, and proper archiving.
• Maintain consistency in all correspondence by adhering to corporate branding standards.
• Take on other responsibilities as assigned.

Requirements

• Possession of a high school diploma or equivalent (GED).
• Exceptional skills in both written and verbal communication.
• Strong abilities in organization and time management.
• Ability to meet production targets of 35 letters per day and 200 letters per week.
• Proven critical thinking and creative problem-solving capabilities.
• Relevant professional experience within the healthcare industry.
• An associate degree in a healthcare-related field is preferred.
• Working knowledge of MS SharePoint.
• Hands-on experience with Utilization Management, government healthcare programs, and managed care processes, including organizational determinations, approvals, denials, appeals, and grievances.
• Adept at performing moderately complex communication tasks, with experience in training others and collaborating across teams.
• Demonstrated adaptability to evolving tasks and a professional, objective approach to collaboration.