Role Description Are you a Pharmacist looking to take the next step in your career? Do you dream of a role that not only allows you to continue your passion for healthcare but also offers a refreshing change of pace and work environment? If so, consider the exciting opportunity of becoming a Medical Information Specialist in Medical Information and Medical Affairs with Med Communications International. - Scientific Advancement: - Dive Deeper into Medicine: As a Medical Information Specialist, you'll have the chance to delve deeper into the world of pharmaceuticals and healthcare. You'll be on the front lines of acquiring, organizing, and disseminating critical medical information. - Stay Updated: Pharmaceuticals and medical treatments are constantly evolving. By joining Med Communications, you'll stay at the forefront of the latest advancements. - Transferable Skills: Your experience as a Community Pharmacist equips you with valuable skills like patient communication, drug knowledge, and attention to detail. - Quality of Life Improvements: - Work-Life Balance: Say goodbye to long hours standing behind the pharmacy counter. With our remote work option, you can achieve a healthier work-life balance. - Location Flexibility: Embrace the freedom of working from home. Forget about commuting hassles. - Reduced Stress: The fast-paced nature of community pharmacies can be stressful. As a Medical Information Specialist, you'll experience a more calm and structured work atmosphere. - Career Growth: At Med Communications, we value professional development. You'll have opportunities for growth and advancement in a supportive and nurturing environment. - Competitive Compensation: We offer competitive compensation packages, ensuring your hard work is well rewarded. Qualifications - Licensed Pharmacist - Degree: MPharm - PharmD or Pharmaceutical Sciences - Experience: At least 3 to 5 years as a Pharmacist - Fluent: C1 or C2 - German & French Speaker Requirements - Step 1: Proceed to follow the form instructions - Step 2: Our HR team will review your application with feedback - Step 3: If successful, HR will arrange your Introductory call - Step 4: A potential online language assessment - Step 5: 1st formal interview - Step 6: 2nd formal interview - Step 7: Offer Benefits - Work-Life Balance - Location Flexibility - Reduced Stress - Career Growth - Competitive Compensation

• Reviews medical bills and documentation according to guidelines and RW policies and procedures. • Determines if treatment is related and necessary to the covered injury. • Advises reimbursement recommendations are appropriate. • Provides customer service to adjusters, providers, and claimants regarding bill review. • Assesses appropriateness and duration of care provided, for possible utilization review. • Recommends independent medical evaluations (IME) to adjusters when necessary. • Act as a resource to other staff members to facilitate completion of a quality product. • Use appropriate reference material as necessary to perform professional review. • Meets company productivity standards. • Meets company quality standards.

Role Description Acts as Team Lead for specialty programs, medical review, utilization management, and case management areas by providing assistance and support to unit supervisor/manager by giving direction/guidance/training to staff. Ensures appropriate levels of healthcare services are provided. This position is part of the End-Stage Renal Disease QIP Contract. Logistics: - Palmetto GBA - one of BlueCross BlueShield's South Carolina subsidiary companies. Functions as a team leader/senior-level Medical Reviewer. Provides leadership/guidance/direction/training to staff. Maintains a working knowledge of unit functions and the ability to interpret to new hires, department interworking, and workflow. Acts as a resource for staff/external entities troubleshooting as well as resolving issues. Keeps manager informed of any problems/issues that need resolving. - Assists management with monitoring workflow and workloads (including reassignment of work to meet timelines, redirecting work intake source to balance workloads), reporting, and addressing aging issues. - Participates in departmental quality reviews. - Follows a process to ensure quality plan is adhered to and communicated to all parties. - Gives/receives feedback regarding medical review decision making and technical claims processing issues. - Ensures that quality work instructions/forms/documents are developed/revised as needed. - Provides quality service and communicates effectively with external/internal customers in response to inquiries. - Obtains information from internal departments, providers, government, and/or private agencies, etc. to resolve discrepancies/problems. - Participates in compliance initiatives and other directed activities. - Participates/oversees special projects as requested by management. Qualifications - Associate Degree - Nursing OR Graduate of Accredited School of Nursing. Requirements - Four years of clinical experience, OR - Two years of clinical and two years of medical review/utilization review, OR - Combination of health plan, clinical, and business experience totaling four years. Preferred Requirements - ESRD/renal dialysis experience. - Five or more years’ clinical, quality management, or leadership experience as a registered nurse in a Dialysis setting. - Three or more years’ education/training/consulting experience related to Dialysis services (may be concurrent). - Three or more years’ experience in quality management coordination related to Dialysis services (may be concurrent). Required Skills and Abilities - Working knowledge of managed care and various forms of healthcare delivery systems. - Strong clinical experience to include home health, rehabilitation, and/or broad medical surgical experience. - Knowledge of specific criteria/protocol sets and the use of the same. - Working knowledge of word processing and spreadsheet software. - Ability to work independently, prioritize effectively, and make sound decisions. - Good judgment skills. - Demonstrated customer service, organizational, and presentation skills. - Demonstrated proficiency in spelling, punctuation, and grammar skills. - Demonstrated oral and written communication skills. - Ability to persuade, negotiate, or influence others. - Analytical or critical thinking skills. - Ability to handle confidential or sensitive information with discretion. - Ability to lead/direct/motivate others. Required Software and Tools - Microsoft Office. Required License and Certificate - Active, unrestricted RN licensure from the United States and in the state of hire, OR - Active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC).

Role Description We are rapidly expanding our Medical Records Team and are looking for a detail-oriented Documents Reviewer to join us immediately. This is a long-term opportunity for professionals with a healthcare background who are passionate about quality, accuracy, and innovation. As a Records Reviewer, you will serve as the final quality checkpoint before medical records are delivered to clients. You'll work closely with our proprietary AI technology to review, validate, and improve medical summaries, chronologies, and case insights while collaborating with internal teams to continuously enhance our review processes. If you have experience reviewing medical records, strong clinical knowledge, and exceptional attention to detail, we'd love to hear from you. Qualifications - Healthcare or Medical Records Experience (Required) - Previous experience reviewing medical records - Professional healthcare background such as: - Registered Nurse (RN) - Licensed Practical/Vocational Nurse (LPN/LVN) - Medical Assistant - Healthcare Administrator - Medical Records Specialist - Health Information Management (HIM) - Or a similar healthcare-related role - Strong understanding of: - Medical terminology - Clinical documentation - Medical record structures - Healthcare workflows - Technical Skills: - Comfortable working with modern software platforms and AI-powered tools. - Quick learner with the ability to adapt to new technologies. - Strong computer literacy and attention to digital workflows. - Communication Skills: - Excellent written English communication skills. - Ability to write clear, concise, and professional documentation. - Comfortable communicating issues and recommendations to internal teams. - Core Competencies: - Exceptional attention to detail with a commitment to producing high-quality work. - Strong analytical and critical thinking skills to interpret medical information accurately. - Clinical judgment to evaluate the relevance and accuracy of medical events and documentation. - Dependability and accountability with the ability to work independently in a remote environment. - Proactive communication by identifying issues early and collaborating with the team. - Long-term commitment and a desire to grow with our company as we continue to scale our AI and medical review capabilities. Requirements - Experience reviewing medical records. - Strong clinical knowledge. - Exceptional attention to detail. Benefits - Long-term opportunity. - Remote work flexibility. How to Apply If you have a healthcare background, experience reviewing medical records, and a passion for quality and accuracy, we'd love to hear from you. Please Apply here: https://operationsarmy.com/application Qualified applicants will be contacted for the next stage of the hiring process.