Remote Clinical QA Coordinator (RN/LPN)

MES Solutions; Norwood (MA); On-site; USD 70,000 - 94,000; Full time

Benefits offered by this job

Medical benefits

Vision benefits

Dental benefits

Paid time off

401k

Job summary

MES Solutions is seeking a self-driven RN or LPN to join as Clinical Quality Assurance Coordinator. This 100% remote role focuses on quality assurance of peer review reports, ensuring evidence-based rationales, references, and compliance with client agreements and regulatory standards.

You will review reports, verify credentials, resolve inconsistencies, and assist with customer issues while maintaining confidentiality. Requires active nursing license and 2+ years clinical experience.

Qualifications

• Active RN/LPN nursing license required.
• Graduate of an accredited nursing program; bachelor's degree preferred.
• Minimum of two years clinical or related field experience.
• Strong knowledge of medical terminology, anatomy/physiology, medications and labs.
• Must type at least 40 WPM and operate common office tech.
• Proficient in Word, Outlook, Excel; able to compute rates/percentages.
• Excellent English usage, grammar, punctuation and style.
• Ability to work independently and maintain confidentiality.

Responsibilities

• Perform quality assurance review of peer review reports and addendums.
• Provide clear, evidence-based rationales supporting recommendations.
• Ensure client instructions and specifications are followed.
• Verify references are current and from reputable medical sources.
• Ensure reports meet high quality and company standards.
• Confirm appropriate board specialty review and accurate documentation.
• Verify absence of conflicts of interest in attestations.
• Ensure provider credentials and signatures on final reports.
• Identify inconsistencies and coordinate with Peer Reviewer for corrections.
• Assist in resolution of customer complaints and QA issues.
• Ensure ERISA/state mandates are adhered to.
• Provide management with QA insights on compliance and resources.
• Participate in training activities and other duties as assigned.

Skills

Communication skills

Typing 40 WPM

English proficiency

Education

RN/LPN license

Accredited nursing program graduate

Bachelor's degree preferred

Tools

Microsoft Word

Microsoft Outlook

Microsoft Excel

Internet

Job description

MES Solutions is seeking a self-driven RN or LPN to join as Clinical Quality Assurance Coordinator. This 100% remote role focuses on quality assurance of peer review reports, ensuring evidence-based rationales, references, and compliance with client agreements and regulatory standards.

You will review reports, verify credentials, resolve inconsistencies, and assist with customer issues while maintaining confidentiality. Requires active nursing license and 2+ years clinical experience.