Clinical Proofreader Editor
Core
Reviewing clinical system events and member/provider correspondence to ensure compliance, accuracy, and adherence to regulatory guidelines and corporate branding.
Role type
Clinical Proofreader/Editor
Builds
Member and provider communications
Domain
Healthcare / Managed Care
Deliverable
client delivery
Required skills
Medical terminology, Utilization Management processes, government healthcare programs, managed care processes (determinations, approvals, denials, appeals, grievances), regulatory compliance, MS SharePoint, written communication, organization, time management
Preferred skills
Associate degree in healthcare, training others, collaborating across teams
Technologies
MS SharePoint
Responsibilities
Review correspondence for accuracy against TruCare records and regulatory guidelines; Audit correspondence to confirm appropriate template usage; Identify process gaps and provide feedback to reduce errors; Support management of correspondence lifecycle including creation, storage, and archiving; Collaborate with care managers and leadership to maintain compliance; Assess correspondence for accurate medical terminology.
