Remote Clinical Quality Assurance Coordinator (RN/LPN)

MES Solutions; Norwood (MA); Remote; USD 37,000 - 43,000; Full time

Benefits offered by this job

Medical, vision and dental insurance

401k plan

Paid time off

Job summary

MES Solutions is seeking a Clinical Quality Assurance Coordinator (RN/LPN) for a fully remote role based in Norwood, MA. You will review peer review reports, ensure evidence-based rationales, and maintain compliance with client specifications and regulatory standards.

The ideal candidate has an active RN or LPN license, at least two years in a clinical setting, strong medical terminology knowledge, and proficiency with Word, Outlook and Excel.

Qualifications

• Active RN or LPN license required.
• Minimum of two years clinical or related field experience.
• Strong knowledge of medical terminology, anatomy & physiology, medications and laboratory values.
• Proficient with MS Word, Outlook, Excel; capable of 40 WPM typing.

Responsibilities

• Performs quality assurance review of peer review reports, correspondences, addendums or supplemental reviews.
• Ensures evidence-based rationales support all recommendations and determinations.
• Verifies client instructions and specifications are followed and questions addressed.
• Ensures reports are cited with current, reputable medical sources.
• Maintains high-quality content, format and professional appearance per company standards.
• Ensures appropriate board specialty review and attestation of no conflicts of interest.
• Maintains provider credentials and signature compliance on final reports.
• Assists in resolving customer complaints and QA issues as needed.
• Adheres to federal ERISA/state mandates; supports management with QA guidance.
• Participates in training activities and contributes to process improvements.

Skills

Medical terminology

Anatomy & physiology

Communication

Confidentiality

Time management

Typing 40 WPM

Education

Active RN/LPN license

Bachelor's degree preferred

Tools

Microsoft Word

Outlook

Excel

Internet research

Job description

MES Solutions is seeking a Clinical Quality Assurance Coordinator (RN/LPN) for a fully remote role based in Norwood, MA. You will review peer review reports, ensure evidence-based rationales, and maintain compliance with client specifications and regulatory standards.

The ideal candidate has an active RN or LPN license, at least two years in a clinical setting, strong medical terminology knowledge, and proficiency with Word, Outlook and Excel.