Medical Case Manager/Claim Reviewer - MEDICAL AUDIT PROFESSIONALS

May 24, 2020


Immediate vacancy available. We are looking for a foreign medical graduate, Spanish, English speaker with an excellent work ethic. no experience is required. we will train. This is a Full-time job as follow:


M-F : 900AM EST- 500PM EST At the Operation office in Miami Shores area


Once candidate passes the proper training, candidate will be working at the office.


The right candidate must be a foreign medical graduate initially, have the ability to start immediately working and handling medical benefits verification and medical pre-authorization service, inpatient care review, itemized bill review, must be able to cover phone calls from 900am EST through 500pm EST. In addition, the candidate must have excellent verbal communication skills, computer proficiency, and customer service experience.



  • Answer inbound calls (3-5 calls/day during the week )

  • eMail monitoring for emergencies average 25 eMails per day

  • Handle providers inquiries for benefit verification

  • Manage and resolve customer complaints

  • Provide customers pre-authorization for medical services.

  • Medical records review

  • itemized Bill Review

  • Escalate priority issues

  • Document all activities and call information according to standard operating procedures

  • reviewing medical records and assess for pre-existing condition and relevant exclusions on the policy


Core Competencies:

  • Must be Foreign Medical Graduate.

  • Must have not passed USMLE STEP1 STEP 2 Nor CSA

  • Verbal and written communication skills ( ENGLISH & SPANISH , other languages) are welcomed

  • MS Access/Word/Excel proficiency

  • Listening skills

  • Problem-solving

  • Customer service oriented

  • Organizational skills

  • Detail oriented

  • Adaptability

  • Team player

  • Resilience


Job Type: Full-time, Part-Time, Contract



  • Spanish and English (required) and Portuguese (preferred), any other languages are welcomed in addition to the required ones.


Job Types: Full-time, Contract


Salary: $28,800.00 to $30,720.00 /year


Contract Length:

  • 1 year


Contract Renewal:

  • Likely


Full Time Opportunity:

  • Yes








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