Remote RN: Clinical Quality Assurance Coordinator

MES Solutions; United States; On-site; USD 75,000 - 110,000; Full time

Benefits offered by this job

Remote work

Medical benefits

Vision benefits

Dental benefits

Paid time off

401k

Job summary

MES Solutions is seeking a Registered Nurse (RN) to join as Clinical Quality Assurance Coordinator. The role focuses on ensuring peer review reports meet high standards while aligning with client expectations and regulatory guidelines.

It is fully remote with a flexible schedule including shifts across EST time, weekends on a rotating basis. The position emphasizes QA review, evidence-based rationales, and strict adherence to clinical and legal requirements.

Qualifications

• Active nursing license required.
• Minimum two years clinical or related field experience.
• Knowledge of the insurance industry (workers' comp, no-fault, liability, disability).
• Strong knowledge of medical terminology, anatomy, physiology, medications and labs.
• Qualified typist, min 40 WPM.
• Proficient with MS Word, Outlook, Excel and Internet.
• Excellent English usage, grammar and style.
• Ability to follow instructions and work with management directions.
• Demonstrates accuracy, quality focus and confidentiality.

Responsibilities

• Perform quality assurance review of peer review reports, correspondences, addendums or supplemental reviews.
• Provide evidence-based rationales and ensure client instructions are followed.
• Ensure reports include clinical citations, current references and professional appearance.
• Verify proper board specialty review per client specs or state mandates.
• Confirm reviewer lacks conflicts of interest and attests to factual accuracy.
• Identify inconsistencies and obtain clarifications from the Peer Reviewer as needed.
• Assist in resolving client complaints and QA issues.
• Ensure compliance with ERISA and state mandates at all times.
• Share insights to management regarding quality, availability and policy adherence.

Skills

Clinical experience

Attention to detail

Strong communication

Typing 40 wpm

Medical terminology

English proficiency

Independent work

Confidentiality

Medical documentation

Education

High school diploma or equivalent

Tools

Microsoft Word

Outlook

Excel

Job description

MES Solutions is seeking a Registered Nurse (RN) to join as Clinical Quality Assurance Coordinator. The role focuses on ensuring peer review reports meet high standards while aligning with client expectations and regulatory guidelines.

It is fully remote with a flexible schedule including shifts across EST time, weekends on a rotating basis. The position emphasizes QA review, evidence-based rationales, and strict adherence to clinical and legal requirements.