Clinical Quality Assurance Coordinator

MES Solutions; United States; Remote; USD 60,000 - 80,000; Part time

Job summary

A leading company is seeking a part-time RN for a remote Clinical Quality Assurance Coordinator role. Responsibilities include quality assurance reviews, ensuring compliance with standards, and maintaining high report quality. Ideal candidates will have clinical experience and strong communication skills.

Benefits

Medical Benefits

Vision Benefits

Dental Benefits

Paid Time Off

401k

Qualifications

• At least two years of clinical or related experience.
• Knowledge of the insurance industry preferred.

Responsibilities

• Perform quality assurance review of peer review reports.
• Ensure compliance with federal ERISA and state mandates.

Skills

Medical Terminology

Communication

Confidentiality

Education

High School Diploma

Tools

Microsoft Office Suite

Job description

Job Details

Job Location: Norwood, MA

Position Type: Part Time

Salary Range: $29.00 - $31.25 Hourly

Travel Percentage: None

Description

Are you an RN looking for a weekend part-time position that is challenging, will keep your clinical skills sharp, and allows you to work from the comfort of home?

MES Solutions is seeking a self-motivated, high-performing registered nurse (RN) to join our team.

The Clinical Quality Assurance Coordinator is responsible for ensuring peer review case reports are of the highest quality and integrity, fully compliant with client contractual agreements, regulatory agency standards, and federal and state mandates.

This position is 100% remote with a schedule on Saturday and Sunday, 7:00 am - 3:30 pm or 10:00 am - 6:30 pm EST.

Responsibilities

• Perform quality assurance review of peer review reports, correspondences, addendums, or supplemental reviews.
• Ensure clear, evidence-based rationales support all recommendations and determinations.
• Follow all client instructions and specifications, addressing all questions.
• Support reviews with current, reputable medical citations and references.
• Maintain high standards for report content, format, and appearance in line with company standards.
• Verify appropriate board specialty review per client and state requirements, documented accurately.
• Ensure peer reviewer attests only to facts, with no conflicts of interest.
• Adhere provider credentials and signatures to final reports.
• Identify report inconsistencies and coordinate with peer reviewers for clarification or correction.
• Assist in resolving client complaints and quality issues.
• Ensure compliance with federal ERISA and state mandates.
• Provide insights to management regarding quality, availability, and policy adherence.
• Promote efficient use of company resources.
• Participate in educational or training activities as required.
• Perform other duties as assigned.

Qualifications

High school diploma or equivalent required, with at least two years of clinical or related experience, or an equivalent education and experience combination. Knowledge of the insurance industry, especially claims management in categories such as workers' compensation, no-fault, liability, and disability, is preferred.

• Strong knowledge of medical terminology, anatomy, physiology, medications, and lab values.
• Proficient in basic math skills including rates and percentages.
• Qualified typist with a minimum of 40 W.P.M.
• Ability to operate general office equipment and software, including Microsoft Office Suite.
• Excellent command of English language, grammar, punctuation, and style.
• Ability to follow instructions accurately and respond to management directions.
• Demonstrate accuracy, thoroughness, and a commitment to quality.
• Exceptional communication skills, including effective listening and clarification questions.
• Ability to work independently, prioritize tasks, and maintain confidentiality.

MES Solutions has been a leader in independent medical examination and peer review services since 1978, serving the insurance, corporate, legal, and government sectors across the nation.

We offer a fast-paced team environment with competitive benefits including medical, vision, dental, paid time off, and 401k.

We are an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, veteran status, or any other protected category under applicable laws.