Clinical Quality Assurance Coordinator
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Job Description
Clinical QA Coordinator reviewing peer-review reports for ExamWorks’ healthcare services. Ensuring evidence-based accuracy, regulatory compliance, and client-specific quality standards.
Responsibilities:
- 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
- Ensure clinical citations and current references from reputable medical journals or publications support reviews when applicable
- Ensure report content, format, appearance, and compliance with company standards
- Verify appropriate board specialty review and accurate case-report documentation
- Verify peer-reviewer attestations 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, modification, 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 assigned duties
Requirements:
- Open exclusively to Registered Nurses (RNs)
- Nursing license
- Strong knowledge of medical terminology, anatomy and physiology, medications, and laboratory values
- Ability to perform arithmetic with whole numbers and decimals and compute rates and percentages
- Qualified typist; minimum of 40 W.P.M. preferred
- 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 skills
- Ability to follow instructions and respond accurately to upper management’s directions
- Accuracy and thoroughness
- Exceptional communication skills
- Ability to work independently, prioritize work, and use time efficiently
- Ability to maintain confidentiality
- Ability to demonstrate and promote a positive team-oriented environment
Benefits:
- 100% Remote - Skip the commute and work from home
- Work-Life Balance - Monday-Friday, 10:00am-6:30pm CT
- Supportive leadership
- Strong benefits
- Opportunities for advancement
- Medical, vision, and dental benefits
- Paid time off
- 401k
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