Remote Clinical QA Specialist (RN/LPN)

Paycom - ATS; Madison (WI); Remote; USD 70,000 - 95,000; Full time

Benefits offered by this job

Healthcare benefits

401k

Paid time off

Remote work

Job summary

ExamWorks is seeking a self-driven RN or LPN to join our team as a Clinical Quality Assurance Coordinator. This 100% remote role supports peer review reports, ensuring high quality, evidence-based rationales, and compliance with client specifications and regulatory standards.

You will verify citations, maintain report integrity, and assist with customer issues while coordinating with peers to resolve discrepancies. Strong nursing credentials and two years of clinical experience are required.

Qualifications

• Active RN/LPN nursing license required.
• Graduate of an accredited nursing program or related medical experience; bachelor’s degree preferred.
• A minimum of two years clinical or related field experience; or equivalent combination of education and experience.
• Strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values.
• Must be able to use basic software programs, including Microsoft Word, Outlook, and Excel; proficient typing (≈40 WPM).
• Excellent English usage, grammar, punctuation and style; ability to follow instructions precisely.

Responsibilities

• Perform quality assurance review of peer review reports, correspondences, addendums or supplemental reviews.
• Provide evidence-based rationales supporting recommendations and determinations.
• Ensure client instructions and specifications are followed and questions addressed.
• Verify references and citations are current and from reputable journals.
• Ensure report content, format, and appearance meet high quality and company standards.
• Confirm board specialty review and absence of reviewer conflicts on the case report.
• Identify inconsistencies and obtain clarifications from the Peer Reviewer as needed.
• Assist in resolving customer complaints and QA issues.
• Ensure compliance with ERISA and state mandates at all times.
• Provide insights to management on consultant quality and policy adherence.
• Promote efficient use of company resources and participate in trainings.

Skills

Nursing license

Clinical experience

Medical terminology

Attention to detail

Communication skills

Typing 40 WPM

Time management

Independent worker

Education

RN/LPN licensure

Bachelor's degree preferred

Tools

Microsoft Word

Outlook

Excel

Internet

Job description

ExamWorks is seeking a self-driven RN or LPN to join our team as a Clinical Quality Assurance Coordinator. This 100% remote role supports peer review reports, ensuring high quality, evidence-based rationales, and compliance with client specifications and regulatory standards.

You will verify citations, maintain report integrity, and assist with customer issues while coordinating with peers to resolve discrepancies. Strong nursing credentials and two years of clinical experience are required.