Clinical Quality Assurance Coordinator – Supervisor

🔥 0 minutes ago

🍂 Massachusetts – Remote

🍂 Massachusetts – Remote

💵 $85k - $90k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔧 QA Engineer (Quality Assurance)

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

MES Solutions

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1978

⚕️ Healthcare Insurance

🤝 B2B

🏛️ Government

Healthcare Insurance • B2B • Government

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

• Oversee the daily workflow of the Quality Assurance Department and provide leadership and direction to ensure operations run as efficiently and effectively as possible. • Coordinate and direct the QA department’s daily workflow to ensure all product lines are completed with the highest level of quality in the most effective and efficient manner possible. • Prioritize and manage the daily workload and ensure the appropriate and equitable distribution of work is maintained in order to achieve goals. • Monitor work product to ensure clear, concise, evidence-based rationales have been provided in support of all recommendations or determinations and that specific indicators and criteria in accordance with company policy and procedures have been achieved. • Ensure department compliance of all federal ERISA and state mandates is adhered to at all times. • Promote effective and efficient utilization of all clinical resources and makes necessary recommendations for improvements to management as needed. • Ensure all client relationships are maintained and all client specific requirements are met. • Assist promptly in resolution of any physician and/or customer complaints or quality assurance issues. • Delegate work as needed and provide backup to all departmental positions as required. • Provide insight and direction to management on consultant quality, availability and compliance with all company policies and procedures. • Participate in the development and implementation of policies and procedures in order to promote and achieve the most efficient operation possible. • Participate in various educational and or training activities as required. • Perform other duties as assigned.

🎯 Requirements

• High school diploma or equivalent required • A minimum of three years related experience; or equivalent combination of education and experience preferred • Knowledge of the insurance industry, preferably claims management relative to workers' compensation, no-fault, liability, and disability is preferred • Previous supervisory experience preferred • Must possess a working knowledge of medical legal aspects of medical records and health information principles and/or liability • Must possess complete knowledge of general computer, fax, copier, scanner, and telephone • Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Excel, and the Internet • Must be a qualified typist with a minimum of 40 W.P.M. • Must demonstrate exceptional communication skills. • Analyzes problems involving multiple interrelated causes. • Gathers information and applies complex concepts or methods to generate an effective solution. • Ability to follow instructions and respond to upper managements’ directions accurately. • Must demonstrate accuracy, thoroughness, and responsibility for quality of work, and ability to take initiative to identify improvements. • Looks for ways to improve and promote quality and monitors own work to ensure quality is met. • Must be able to work independently, prioritize work activities and use time efficiently. • Must be able to take independent actions and calculated risks when needed. • Must use good judgment and include the appropriate people in the decision-making process. • Must be able to maintain confidentiality. • Must be able to demonstrate and promote a positive team -oriented environment. • Must be able to stay focused and concentrate under normal or heavy distractions. • Must be able to work well under pressure and or stressful conditions. • Must possess the ability to manage and direct change, delays, or unexpected events appropriately. • Ability to follow all company policies and procedures in effect at time of hire and as they may change or be added from time to time.

🏖️ Benefits

• Competitive benefits (medical, vision, dental) • Paid time off • 401k