Remote Clinical QA Coordinator — RN/LPN

MES Solutions; Norwood (MA); On-site; USD 85,000 - 110,000; Full time

Benefits offered by this job

Remote work (home-based)

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 reviewing peer review reports with evidence-based rationales and ensuring compliance with client agreements and regulations.

You will verify provider credentials, coordinate with Peer Reviewers, and ensure the highest quality reports while meeting state and federal mandates. Strong clinical knowledge and detailed documentation are essential.

Qualifications

• Active RN or LPN nursing license required.
• Graduate of an accredited nursing program; bachelor’s preferred.
• Two years of clinical or related experience minimum.
• Strong knowledge of medical terminology, anatomy, physiology, meds, and labs.
• Proficient with Word, Outlook, Excel; able to type well.

Responsibilities

• Perform QA review of peer review reports, addenda, and reviews.
• Provide clear, evidence-based rationales for recommendations.
• Follow client instructions and address all questions.
• Support with clinical citations and current references.
• Ensure reports meet quality and client standards.
• Verify board specialty review and document accordingly.
• Confirm reviewer attests to facts with no conflicts.
• Ensure provider credentials and signatures on final reports.
• Identify inconsistencies and obtain needed corrections.
• Assist in resolution of customer quality issues as needed.
• Adhere to ERISA/state mandates at all times.
• Provide guidance on quality, availability, and compliance.
• Promote efficient use of company resources; participate in training.
• Perform other duties as assigned.

Skills

QA reviews

Clinical terminology

Attention to detail

Communication skills

Independence

Education

RN license

LPN license

Bachelor's degree (preferred)

Tools

MS Word

Outlook

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 reviewing peer review reports with evidence-based rationales and ensuring compliance with client agreements and regulations.

You will verify provider credentials, coordinate with Peer Reviewers, and ensure the highest quality reports while meeting state and federal mandates. Strong clinical knowledge and detailed documentation are essential.