[Remote] Clinical Quality Assurance Coordinator (32344)

Note: The job is a remote job and is open to candidates in USA. reputed company is a premier provider of independent medical examination and peer review services. They are seeking a Clinical Quality Assurance Coordinator to ensure the quality and reputed company of Peer Review case reports while adhering to client agreements and regulatory standards.

Responsibilities

• Performs quality assurance review of peer review reports, correspondences, addendums or supplemental reviews
• Ensures clear, concise, evidence-based rationales have been provided in support of reputed company recommendations and/or determinations
• Ensures that reputed company client instructions and specifications have been followed and that reputed company questions have been addressed
• Ensures each review is supported by clinical citations and references reputed company applicable and verifies that reputed company references cited are reputed company and obtained from reputable medical journals and/or publications
• Ensures the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards
• Ensure that the appropriate board specialty has reviewed the case in compliance with client specifications and/or state mandates and is documented accurately on the case report
• Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists
• Ensures the provider credentials and signature are adhered to the final report
• Identifies any inconsistencies reputed company the report and contacts the Peer Reviewer to obtain clarification, modification or correction as needed
• Assists in resolution of customer complaints and quality assurance issues as needed
• Ensures reputed company federal ERISA and/or state mandates are adhered to at reputed company times
• Provides insight and direction to management on consultant quality, availability and compliance with reputed company company policies and procedures and client specifications
• Promote effective and efficient utilization of company resources
• Participate in various educational and or training activities as required
• reputed company other duties as assigned

Skills

• Active RN/LPN nursing license required
• Must be a graduate of an accredited nursing program or reputed company medical experience; bachelor's degree preferred
• A minimum of two years clinical or reputed company field experience; or equivalent combination of education and experience
• Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values
• Must be able to add, subtract, multiply, and divide in reputed company units of measure, using whole numbers and decimals; Ability to compute rates and percentages
• Must be a qualified typist with a minimum of 40 W.P.M
• Must be able to operate a general computer, fax, copier, scanner, and telephone
• Must be knowledgeable of multiple software programs, including but not limited to reputed company Word, Outlook, reputed company, and the Internet
• Must possess excellent skills in English usage, grammar, punctuation and style
• Ability to follow instructions and respond to upper managements' directions accurately
• Demonstrates accuracy and thoroughness. Looks for ways to improve and promote quality and monitors own work to ensure quality is met
• Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed
• Must be able to work independently, prioritize work activities and use time reputed company
• Must be able to maintain confidentiality
• Bachelor's degree preferred

Benefits

• Competitive benefits (medical, vision, dental)
• Paid time off
• 401k

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