Remote Clinical Appeals Education & QA Lead

Managed Resources, Inc (MRI); United States; Remote; USD 69,000 - 79,000; Full time

Benefits offered by this job

Medical,Dental,Vision

Phone stipend

Internet stipend

401(k) match

Paid time off

Holidays

Job summary

Managed Resources, Inc. is seeking a Clinical Appeals Education and Quality Assurance Coordinator for a fully remote, full-time role in the United States.

You will own and enhance the education and QA program across clinical appeals, coding, and denial management workflows, partnering with leadership to drive standardized training and improve client outcomes. The role requires RN and/or coding certification, with expertise in QA programs, InterQual, CMS guidelines, and payer policies.

Qualifications

• RN or coding certification required.
• Experience leading QA programs and training.
• Knowledge of InterQual, CMS guidelines and payer policies.

Responsibilities

• Own and enhance the Clinical Appeals education and QA program.
• Develop QA methodologies, scoring rubrics, and audits.
• Create centralized knowledge base for training materials.
• Lead onboarding programs for new hires and track effectiveness.
• Translate audit findings into performance improvements.

Skills

QA program ownership

Audit frameworks

Adult learning

Training leadership

Healthcare revenue cycle

Education development

InterQual knowledge

CMS guidelines

Payer policies

Regulatory awareness

Education

RN certification

CCS

CPC

CCDS

CDIP

Tools

InterQual

Milliman

CMS guidelines

Payer policies

Job description

Managed Resources, Inc. is seeking a Clinical Appeals Education and Quality Assurance Coordinator for a fully remote, full-time role in the United States.

You will own and enhance the education and QA program across clinical appeals, coding, and denial management workflows, partnering with leadership to drive standardized training and improve client outcomes. The role requires RN and/or coding certification, with expertise in QA programs, InterQual, CMS guidelines, and payer policies.