Clinical Quality Assurance Coordinator
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Clinical Quality Assurance Coordinator reviewing peer-review reports for MES Solutions, a provider of independent medical examination and peer review services. Ensuring clinical accuracy, compliance, and report quality remotely.
Responsibilities:
- 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, specifications, questions, clinical citations, and current reputable references are addressed
- 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 inconsistencies and contact peer reviewers for clarification, modification, or correction
- Assist with customer 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 required educational and training activities
- Perform other duties as assigned
Requirements:
- Active RN or LPN nursing license required
- Graduate of an accredited nursing program or related medical experience
- Minimum of two years clinical or related field experience, or equivalent combination of education and experience
- Bachelor's degree preferred
- Strong knowledge of medical terminology, anatomy and physiology, medications, and laboratory values
- Ability to compute rates and percentages
- Qualified typist with a minimum of 40 W.P.M.
- 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
- Ability to follow instructions accurately
- Exceptional communication skills
- Ability to work independently, prioritize activities, and use time efficiently
- Ability to maintain confidentiality
Benefits:
- Fully remote work
- Medical, vision, and dental benefits
- Paid time off
- 401k
- No travel required
Similar Jobs
Senior Financial Crimes Quality Assurance (QA) Analyst
Financial Crimes QA Sr. Analyst strengthening BSA/AML, Sanctions, and Fraud oversight. Improving quality reviews and governance at Pathward, a financial empowerment company.
Financial Crimes QA Analyst II
Financial Crimes QA Analyst II reviewing BSA/AML, sanctions, and fraud oversight for Pathward, a financial empowerment company. Challenging decisions and improving regulatory risk governance.
Financial Crimes QA Analyst I
Financial crimes QA analyst reviewing BSA/AML, sanctions, and fraud oversight for Pathward, a financial empowerment company. Testing 2LoD governance, challenging decisions, and strengthening risk management.
Legal Engineer – QA
Legal Engineer improving legal AI quality for NetDocuments’ intelligent document management platform. Building evaluations, software tools, and agentic workflows for legal product teams.
QA Audio Rater – English (Australia)
QA Audio Rater auditing audio-rating quality for Welo Data’s AI services in Australia. Identifying calibration issues and improving rater consistency during the pilot program.
Fullstack QA Engineer – MSME
QA Engineer owning manual testing for Salmon’s mobile, web, and backend fintech products. Testing APIs, releases, browsers, devices, and CI/CD workflows for MSME users.
Penetration Tester
Penetration Tester conducting web, mobile, API, and network assessments for Velero’s cybersecurity and compliance consulting clients. Delivering actionable findings that strengthen security posture and regulatory readiness.
QA Lead – Insurance
QA Lead Sênior estruturando estratégia, governança e testes para projetos complexos de seguros. Liderando equipes e garantindo qualidade, rastreabilidade e segurança nas entregas.
Senior Insurance Operations Quality Assurance Specialist
Senior QA specialist auditing complex Supplemental Health claims for Horace Mann, an educator-focused insurance and financial services company. Analyzing compliance, trends, and process improvements.
Test Analyst
Test Analyst certifying bank, acquirer and PSP integrations for EPI’s Wero digital wallet. Investigating APIs, logs and distributed services across Europe’s payment network.
Quality Assurance Engineer, Mid-Senior, Mobile
Mobile QA Engineer testing Coveron’s identity theft protection platform across iOS and Android. Building automated tests and supporting secure identity-protection releases.
SAP Business Technology Platform Quality Engineer
SAP BTP Quality Engineer building reusable test automation for Seamless Migration, a company enabling organizations through business automation. Testing BTP services, frameworks, and integrations.
Freelance Software Tester – Smart TVs
Freelance software tester evaluating streaming apps for Testlio, a global software testing company. Executing functional tests and reporting defects on Titan OS Smart TVs.
Freelance Software Tester, Smart TVs
Freelance Smart TV software tester in Germany testing Testlio’s streaming app. Executing functional tests and reporting bugs across Titan OS devices.
Senior QA Engineer
Senior QA Engineer owning Playwright/TypeScript automation and end-to-end quality for Aphex’s construction planning platform. Embedding with product teams to deliver reliable releases.
Mid-Level Quality Engineer
Quality Engineer owning automated testing and quality strategy for webhook integrations. CI&T delivers AI-powered technology transformation and business solutions for large enterprises.
Quality Assurance Supervisor
Quality Assurance Supervisor reviewing workforce-program case files, data, payments, and compliance. Supporting Career Team’s technology-enabled services that help job seekers achieve measurable outcomes.
CAD Survey Technician, QA
Residential CAD survey checker reviewing complex land surveys and coordinating boundary matters. Coaching drafting teams and supporting Professional Land Surveyors at Exacta.
IT QA Manager
IT QA Manager leading people, governance, testing, and automation across Guild Mortgage’s home-financing technology. Driving quality outcomes, delivery confidence, and customer-focused software delivery.
QA Functional Analyst – Temporary
QA Functional Analyst validating business workflows, transactions, and data across application layers. Testing AI-powered solutions for Applaudo under a temporary three-month engagement.