Clinical Quality Assurance Coordinator (32445)
$58,240–$65,000 year
RemoteUnited States or Norwood, Massachusetts, United States
Job Summary
Conduct quality assurance reviews of peer review reports, correspondences, and addendums to ensure evidence-based rationales, current clinical citations, and compliance with client specifications and federal mandates. Verify provider credentials, reviewer attestations, and absence of conflicts of interest while identifying inconsistencies to request clarifications or corrections from peer reviewers. Assist in resolving customer complaints and quality assurance issues, providing management insights on consultant quality and compliance with company policies. Maintain confidentiality and promote efficient utilization of resources while participating in required educational activities. This role supports MES Solutions' national delivery of independent medical examinations and peer review services to the insurance, corporate, legal, and government sectors.
Required Qualifications
- Active RN nursing license
- Must be a graduate of an accredited nursing program or related medical experience
- Bachelor's degree preferred
- A minimum of two years clinical or related field experience
- Equivalent combination of education and experience
- Strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values
- Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers and decimals
- Ability to compute rates and percentages
- Must be a qualified typist with a minimum of 40 W.P.M
- Ability to operate a general computer, fax, copier, scanner, and telephone
- Knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet
- Excellent skills in English usage, grammar, punctuation and style
- Ability to follow instructions and respond to upper managements' directions accurately
- Demonstrates accuracy and thoroughness
- Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed
- Must be able to work independently, prioritize work activities and use time efficiently
- Must be able to maintain confidentiality
- Friday is mandatory for one of the 12-8:30 shifts
Desired Qualifications
- Bachelor's degree preferred
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