Clinical Quality Assurance Coordinator

🔥 0 minutes ago

🌽 Illinois – Remote

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💵 $28 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔧 QA Engineer (Quality Assurance)

👻 Ghost score 0%

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Logo of ExamWorks

ExamWorks

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, and questions are addressed • Ensure reviews include current, reputable clinical citations and references when applicable • Ensure report content, format, and professional appearance meet company standards • Verify appropriate board specialty review and accurate case-report documentation • Verify peer-reviewer attestations 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 • 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 required educational and training activities • Perform other assigned duties

🎯 Requirements

• Open exclusively to Registered Nurses (RNs) • Nursing license • Strong knowledge of medical terminology, anatomy and physiology, medications, and laboratory values • Ability to perform arithmetic calculations using whole numbers and decimals • Ability to compute rates and percentages • Qualified typist; minimum of 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 skills • Ability to follow instructions and respond accurately to upper management directions • Accuracy and thoroughness • Exceptional communication skills • Ability to work independently, prioritize work activities, and use time efficiently • Ability to maintain confidentiality • Ability to demonstrate and promote a positive team-oriented environment

🏖️ Benefits

• 100% Remote - Skip the commute and work from home • Work-Life Balance - Monday-Friday, 8:00am-4:30pm CT • Supportive leadership • Strong benefits • Opportunities for advancement • Medical, vision, and dental benefits • Paid time off • 401k

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