Remote Clinical Quality Assurance Coordinator (RN/LPN)

Paycom; Madison (WI); On-site; USD 36,000 - 47,000; Full time

Job summary

ExamWorks is seeking a self-driven RN/LPN to join as a Clinical Quality Assurance Coordinator. You will review peer reports, ensure evidence-based rationales, and confirm client specs and regulatory compliance while maintaining high-quality reports.

Work from home with a schedule of 10:30am-7:00pm EST and occasional weekends/holidays. A nursing license and 2+ years of clinical experience are required, with strong English communication and typing skills.

Qualifications

• Active RN/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; or equivalent education/experience.
• Strong knowledge of medical terminology, anatomy and physiology, medications and lab values.
• Must be able to perform basic math operations and type at 40 WPM or faster.

Responsibilities

• Performs quality assurance review of peer review reports, correspondences, addendums or supplemental reviews.
• Ensures evidence-based rationales are provided for all recommendations/determinations.
• Follows client instructions and specifications; addresses questions.
• Supports reports with clinical citations from reputable journals.
• Ensures reports have high quality content, format, and appearance per standards.
• Verifies board specialty review compliance with client specs/state mandates.
• Checks reviewer attestation to avoid conflicts of interest.
• Confirms provider credentials and signatures on final reports.
• Identifies inconsistencies and coordinates with Peer Reviewer for corrections.
• Assists in resolving customer complaints and QA issues.
• Adheres to ERISA and state mandates; ensures compliance at all times.
• Provides management with insights on consultant quality and policy compliance.
• Promotes efficient use of company resources and participates in training.

Skills

RN or LPN

Medical terminology

English communication

Typing 40 WPM

Education

Accredited nursing program

Bachelor's degree preferred

Tools

Microsoft Word

Excel

Outlook

Internet

Job description

ExamWorks is seeking a self-driven RN/LPN to join as a Clinical Quality Assurance Coordinator. You will review peer reports, ensure evidence-based rationales, and confirm client specs and regulatory compliance while maintaining high-quality reports.

Work from home with a schedule of 10:30am-7:00pm EST and occasional weekends/holidays. A nursing license and 2+ years of clinical experience are required, with strong English communication and typing skills.