Clinical Quality Assurance Coordinator

🔥 12 minutes ago

🍂 Massachusetts – Remote

🍂 Massachusetts – Remote

💵 $27 - $29 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔧 QA Engineer (Quality Assurance)

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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MES Solutions

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1978

🏥 Healthcare

⚖️ Legal

💼 Consulting

Healthcare • Legal • Consulting

MES Solutions is a provider of independent medical evaluation and peer review services for the claims and risk-management community. The company coordinates Independent Medical Examinations (IMEs), record retrieval and record reviews, peer review services, physician credentialing, and fitness-for-duty and disability assessment support. Its clients include insurers, third-party administrators, self-insured employers, government agencies, and attorneys across auto, disability, liability, workers' compensation, and group health markets, and it emphasizes compliance with HIPAA, HITECH, and HITRUST.

📋 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 client instructions, specifications, and questions have been addressed • Confirm clinical citations and references are current and from reputable medical journals or publications • Ensure report content, format, and professional appearance meet company standards • Verify appropriate board specialty review and accurate documentation • Confirm peer reviewer attestation and absence of conflicts of interest • Ensure provider credentials and signature are included in final reports • Identify report inconsistencies and contact peer reviewers for clarification or correction • Assist with customer complaints and quality assurance issues • Ensure compliance with federal ERISA and state mandates • Provide management with insight into 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

• 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 involving whole numbers and decimals, 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

• Medical insurance • Vision insurance • Dental insurance • Paid time off • 401(k) • Fully remote work • Monday through Friday schedule