Remote Clinical QA Coordinator

MES Solutions; United States; Remote; USD 75,000 - 110,000; Full time

Benefits offered by this job

Remote work

Job summary

MES Solutions is seeking a self-driven RN or LPN to join as Clinical Quality Assurance Coordinator, working 100% remotely. You will review peer review reports, ensure clinical rationales are evidence-based, and verify compliance with client agreements and regulatory standards.

The role emphasizes accuracy, confidentiality, and collaboration with management to uphold ERISA/state mandates and high-quality reports.

Qualifications

• Active RN or LPN nursing license required.
• Graduate of an accredited nursing program or related medical experience; bachelor's degree preferred.
• Minimum of two years clinical or related field experience.
• Strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values.
• Able to perform basic arithmetic and compute rates/percentages.
• Proficient typing (minimum 40 WPM) and comfortable with MS Office applications.
• Excellent English usage, grammar and communication skills.
• Ability to work independently, prioritize tasks, maintain confidentiality.

Responsibilities

• Performs quality assurance review of peer review reports and related documents.
• Ensures evidence-based rationales support recommendations and determinations.
• Follows client instructions and addresses all questions.
• Verifies references are current and from reputable journals.
• Maintains high-quality reports in line with company standards.
• Confirms appropriate board specialty review per client specs and state mandates.
• Ensures reviewer attestation of facts and absence of conflicts of interest.
• Ensures provider credentials and signatures are correct on final reports.
• Identifies inconsistencies and coordinates with Peer Reviewer for corrections.
• Assists in resolving customer complaints and QA issues.
• Adheres to federal ERISA and state mandates at all times.
• Provides guidance to management on consultant quality, availability, and compliance.
• Promotes efficient use of company resources and participates in training.

Skills

RN/LPN license

Remote work

Typing 40 WPM

MS Office

Medical terminology

Attention to detail

Education

Accredited nursing program graduate

Bachelor's degree preferred

Tools

Microsoft Word

Excel

Outlook

Internet

Job description

MES Solutions is seeking a self-driven RN or LPN to join as Clinical Quality Assurance Coordinator, working 100% remotely. You will review peer review reports, ensure clinical rationales are evidence-based, and verify compliance with client agreements and regulatory standards.

The role emphasizes accuracy, confidentiality, and collaboration with management to uphold ERISA/state mandates and high-quality reports.