Clinical Quality Assurance Coordinator

🕒 October 7

🧀 Wisconsin – Remote

🧀 Wisconsin – Remote

💵 $30 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔧 QA Engineer (Quality Assurance)

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

🎯 Requirements

• Active RN/LPN nursing license required • Must be a graduate of an accredited nursing program or have related medical experience • Bachelor's degree preferred • Minimum of two years clinical or related field experience, or equivalent combination of education and experience • Strong knowledge of medical terminology, anatomy and physiology, medications, and laboratory values • Ability to perform arithmetic calculations with whole numbers and decimals and compute rates and percentages • Qualified typist with a minimum of 40 W.P.M. • Ability to operate a computer, fax, copier, scanner, and telephone • Knowledge of Microsoft Word, Outlook, Excel, and the Internet • Excellent English usage, grammar, punctuation, and style • Ability to follow instructions and respond accurately to management directions • Demonstrated accuracy and thoroughness • Exceptional communication skills • Ability to work independently, prioritize work, and use time efficiently • Ability to maintain confidentiality

🏖️ Benefits

• Fully remote work arrangement • Medical, vision, and dental benefits • Paid time off • 401k • Fast-paced team atmosphere

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