Clinical Quality Assurance Coordinator

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $24 - $31 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔧 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, correspondence, addendums, and supplemental reviews • Ensure clear, concise, evidence-based rationales support recommendations and determinations • Verify client instructions and specifications are followed and all questions are addressed • Verify clinical citations and references are current and from reputable medical publications • Ensure report content, format, appearance, and compliance with company standards • Verify appropriate board specialty review and accurate documentation • Verify 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 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

• Role open exclusively to RN, LPN, or LVN • Active nursing license required (RN/LPN/LVN) • Graduate of an accredited nursing program or related medical experience • Bachelor's degree preferred • Strong knowledge of medical terminology, anatomy and physiology, medications, and laboratory values • Qualified typist with a minimum of 40 W.P.M. • 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, thoroughness, and quality monitoring • Exceptional communication skills • Ability to work independently, prioritize work, and use time efficiently • Ability to maintain confidentiality • Ability to work well under pressure or stressful conditions • Ability to manage change, delays, or unexpected events appropriately

🏖️ Benefits

• 100% Remote – Enjoy the flexibility of working from home • Predictable Monday–Friday schedule • Competitive benefits: medical, vision, and dental • Paid time off • 401k • Educational and training activities