[Remote] Clinical Quality Assurance Coordinator (32343)

Note: The job is a remote job and is open to candidates in USA. ExamWorks is a leading provider of innovative healthcare services including independent medical examinations and peer reviews. They are seeking a Clinical Quality Assurance Coordinator who will review medical records, identify key details, and create clear summaries while ensuring compliance with quality standards.

Responsibilities

• Perform quality assurance review of peer review reports, correspondences, addendums or supplemental reviews
• Ensure clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations
• Ensure that all client instructions and specifications have been followed and that all questions have been addressed
• Ensure each review is supported by clinical citations and references when applicable and verifies that all references cited are current and obtained from reputable medical journals and/or publications
• Ensure the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards
• Ensure the appropriate board specialty has reviewed the case in compliance with client specifications or state mandates and is documented accurately on the case report
• Verify that the peer reviewer has attested to only the facts and that no evidence of reviewer conflict of interest exists
• Ensure the provider credentials and signature are adhered to the final report
• Identify any inconsistencies within the report and contacts the Peer Reviewer to obtain clarification, modification or correction as needed
• Assist in resolution of client complaints and quality assurance issues as needed
• Ensure all federal ERISA and state mandates are adhered to at all times
• Provide insight and direction to management on consultant quality, availability and compliance with all company policies and procedures and client specifications
• Promote effective and efficient utilization of company resources
• Participate in various educational and or training activities as required
• Perform other duties as assigned

Skills

• Nursing license
• Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values
• Must be able 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 preferred
• Must be able to operate a general computer, fax, copier, scanner, and telephone
• Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet
• Must possess excellent skills in English usage, grammar, punctuation and style
• Ability to follow instructions and respond to upper managements' directions accurately
• Must demonstrate accuracy and thoroughness. Look for ways to improve and promote quality and monitors own work to ensure quality is met
• 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
• Must be able to demonstrate and promote a positive team-oriented environment
• Professional writing experience preferred
• Must be a qualified typist with a minimum of 40 W.P.M preferred

Benefits

• 100% remote – Work from the comfort of home
• Flexible schedule – Training hours are Monday–Friday, 7:30 AM–4:00 PM CT, with flexibility once you’re up to speed (within standard business hours)
• Competitive benefits (medical, vision, dental)
• Paid time off
• 401k

Company Overview