Clinical Quality Assurance Coordinator

🕒 October 14

🇺🇸 United States – Remote

💵 $24 - $31 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔧 QA Engineer (Quality Assurance)

👻 Ghost score 0%

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ExamWorks

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 2008

🏥 Healthcare

💼 Consulting

⚖️ Legal

Healthcare • Consulting • Legal

ExamWorks is a leading provider of independent medical examinations and peer reviews, specializing in services such as bill reviews, Medicare compliance, and document management. With a robust portfolio that includes agile development and enterprise platform solutions, ExamWorks ensures efficient workflow enhancements and compliance auditing across healthcare sectors. The company supports a network of physicians and offers customized services for the management of medical records and claims, prioritizing reliability for clients in various communities.

📋 Description

• Perform quality assurance reviews of peer review reports, correspondences, addendums, and supplemental reviews • Ensure clear, concise, evidence-based rationales support recommendations and determinations • Verify compliance with client instructions, specifications, federal ERISA requirements, and state mandates • Ensure reviews include current, reputable clinical citations and references when applicable • Verify report content, format, professional appearance, and compliance with company standards • Confirm appropriate board specialty review and accurate case-report documentation • Verify peer reviewer attestation and absence of conflicts of interest • Ensure provider credentials and signatures are included in final reports • Identify report inconsistencies and contact Peer Reviewers for clarification, modification, or correction • Assist with client complaints and quality assurance issues • Provide management insight on consultant quality, availability, and compliance • Promote effective and efficient use of company resources • Participate in educational and training activities • Perform other duties as assigned

🎯 Requirements

• Open exclusively to RN, LPN, or LVN • Active nursing license required (RN/LPN/LVN) • Graduate of an accredited nursing program or related medical experience • Strong knowledge of medical terminology, anatomy and physiology, medications, and laboratory values • Qualified typist with a minimum of 40 W.P.M. • Knowledge of Microsoft Word, Outlook, Excel, and the Internet • Excellent English usage, grammar, punctuation, and style skills • Ability to follow instructions and respond accurately to management directions • Accuracy and thoroughness • Ability to work independently, prioritize work, and use time efficiently • Ability to maintain confidentiality • Ability to work in a positive team-oriented environment • Ability to stay focused under normal or heavy distractions • Ability to work well under pressure or stressful conditions • Ability to manage change, delays, or unexpected events appropriately

🏖️ Benefits

• 100% remote work from home • Predictable Monday–Friday schedule • Medical, vision, and dental benefits • Paid time off • 401k • Professional growth opportunities

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