Job Details

Medical Investigator
2 Years
Phoenix, AZ 85007
Position will be in office until they are finished with training and are able to work independently
Hybrid schedule after training will be 3 days at home 2 days in office

DUTIES AND RESPONSIBILITIES:
Conducting investigations for allopathic physicians and physician assistants licensed in Arizona related to quality-of-care allegations and unprofessional conduct. Matters investigated include quality of care allegations, criminal convictions, and sensitive issues such as substance abuse and sexual misconduct.

Duties are equivalent of a paralegal or high-volume case manager. Duties include reviewing the complaint and preparing notice letters to respondent with allegations and reaching out to the complainant; determine appropriate medical records or supporting documents to request by subpoenas; conduct interviews of the respondent, complainant, patient and/or any witnesses; interpret statutes and rules; manage multiple cases at varying stages in the investigative process; prepare case reports and present cases before the Arizona Medical Board; on occasion, testify before the Office of Administrative Hearings; prioritize, plan, organize, and conduct investigations, including site inspections.

SKILLS: Experience in reading and interpreting medical records. Skill in production of timely and accurate reports and documentation. Skills in applying and interpreting Federal and State statutes and rules governing investigations and the practice of medicine. Skill in presenting cases in a hearing or trial setting. Must be able to handle and prioritize a large case load. Medical Assistant / healthcare background, paralegal training, medical billing, and coding experience is a plus.

Top 3 Required Skills: (Non-Negotiable)
1. Effective written and oral communication (including email)
2. Organization and Follow Through
3. Knowledge of Microsoft Office Suites (Word, Adobe PDF)

Top 5 Preferred Skills: (Preferences)
1. Self-Starter: Enthusiasm, Flexibility and Motivation; Work effectively without regularly needing to be told what to do
2. Critical Thinking and Problem-Solving: Identify similar situations following established routines/instructions
3. Team Player: Ability to work with various investigators, internal and external medical physicians, support staff services, and different departments
4. Knowledge of healthcare terminology
5. Medical Assistant / Background in Healthcare

ABILITIES: Ability to conduct investigations, including review of medical records to determine relevance to the investigation. Ability to multi-task, prioritize, plan, analyze, and coordinate investigations. Ability to extract and utilize facts from a variety of sources and apply the relevant statutes, rules and policies to prepare clear, accurate and quality documents within specified time frames.

Day to Day Tasks Include:
• Review complaints, determine allegations, draft notice letters to respondent and contact the complainant
• Request medical records or supporting documents/information relevant to the investigation
• Follow-up on outstanding requests/responses
• Organize (bookmark) medical records/supporting documents to add to the case file
• Determine next steps within the investigation to keep the case moving forward
• Provide status updates when requested to complainant and respondent
• Prepare memos/investigative reports for matters related to unprofessional conduct
• Conduct interviews with complainants, respondents or witnesses
• Prioritize daily tasks
• Update case notes and case status
• Respond to inquiries from the Medical Consultants reviewing cases

Required Skills
Effective written and oral communication (including email)
Organization and Follow Through
Knowledge of Microsoft Office Suites (Word, Adobe PDF)

Preferred Skills
Knowledge of healthcare terminology
Medical Assistant / Background in Healthcare