Clinical Quality Assurance Coordinator

🔥 0 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $26 - $28 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔧 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 review of peer review reports, correspondences, addendums or supplemental reviews • Ensure clear, concise, evidence-based rationales support all recommendations and/or determinations • Ensure client instructions and specifications are followed and all questions are addressed • Ensure reviews are supported by current clinical citations and references from reputable medical journals and publications when applicable • Ensure report content, format, and professional appearance meet company standards • Ensure the appropriate board specialty has reviewed each case according to client specifications or state mandates and is accurately documented • Verify peer reviewer attestation to facts and absence of conflicts of interest • Ensure provider credentials and signature are included on the final report • Identify report inconsistencies and contact Peer Reviewers for clarification, modification, or correction • Assist with client complaints and quality assurance issues • Ensure compliance with federal ERISA and state mandates • 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

• Nursing license • Professional writing experience preferred • Strong knowledge of medical terminology, anatomy and physiology, medications, and laboratory values • Ability to perform arithmetic using whole numbers and decimals and compute rates and percentages • Qualified typist; minimum 40 W.P.M. preferred • 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 upper management directions • Accuracy and thoroughness • Ability to improve and promote quality and monitor own work • Exceptional communication skills, including accurate information conveyance, effective listening, and clarification questions • Ability to work independently, prioritize activities, and use time efficiently • Ability to maintain confidentiality • Ability to promote a positive team-oriented environment

🏖️ Benefits

• 100% Remote - Skip the commute and work from home • Work-Life Balance - Monday-Friday, 7:30am-4:00pm CT • Supportive leadership • Strong benefits • Opportunities for advancement • Competitive benefits: medical, vision, dental • Paid time off • 401k