MES Solutions

QA Engineer

• Perform quality assurance reviews of peer review reports, correspondences, addendums, and supplemental reviews
• Ensure clear, concise, evidence-based rationales support recommendations and determinations
• Verify client instructions, specifications, and questions have been addressed
• Confirm clinical citations and references are current and from reputable medical journals or publications
• Ensure report content, format, and professional appearance meet company standards
• Verify appropriate board specialty review and accurate documentation
• Confirm peer reviewer attestation and absence of conflicts of interest
• Ensure provider credentials and signature are included in final reports
• Identify report inconsistencies and contact peer reviewers for clarification or correction
• Assist with customer complaints and quality assurance issues
• Ensure compliance with federal ERISA and state mandates
• Provide management with insight into consultant quality, availability, and compliance
• Promote effective and efficient use of company resources
• Participate in required educational and training activities
• Perform other assigned duties

Clinical Quality Assurance Coordinator

• Perform quality assurance reviews of peer review reports, correspondence, addendums, and supplemental reviews
• Ensure clear, concise, evidence-based rationales support recommendations and determinations
• Verify client instructions and specifications are followed and all questions are addressed
• Verify clinical citations and references are current and from reputable medical publications
• Ensure report content, format, appearance, and compliance with company standards
• Verify appropriate board specialty review and accurate documentation
• Verify peer reviewer attestation and absence of conflicts of interest
• Ensure provider credentials and signature are included in final reports
• Identify report inconsistencies and contact peer reviewers for clarification or correction
• Assist with client complaints and quality assurance issues
• Ensure compliance with federal ERISA and state mandates
• Provide management insight on consultant quality, availability, and compliance
• Promote effective and efficient use of company resources
• Participate in educational and training activities
• Perform other duties as assigned

• Perform quality assurance reviews of peer review reports, correspondence, addendums, and supplemental reviews
• Ensure clear, concise, evidence-based rationales support recommendations and determinations
• Verify client instructions, specifications, questions, citations, and references are addressed and current
• Ensure reports meet company standards for content, format, and professional appearance
• Verify appropriate board specialty review and accurate documentation
• Verify peer reviewer attestation and absence of conflicts of interest
• Ensure provider credentials and signatures are included in final reports
• Identify report inconsistencies and contact peer reviewers for clarification or correction
• Assist with customer complaints and quality assurance issues
• Ensure compliance with federal ERISA and state mandates
• Provide management insight on consultant quality, availability, and compliance
• Promote efficient use of company resources
• Participate in required educational and training activities
• Perform other assigned duties

• Perform quality assurance review of peer review reports, correspondences, addendums, and supplemental reviews
• Ensure clear, concise, evidence-based rationales support recommendations and determinations
• Ensure client instructions and specifications are followed and all questions are addressed
• Verify clinical citations and references are current and obtained from reputable medical journals or publications
• Ensure report content, format, and professional appearance comply with company standards
• Confirm the appropriate board specialty reviewed each case in compliance with client specifications and state mandates
• Verify peer reviewer attestations and absence of reviewer conflicts of interest
• Ensure provider credentials and signatures are included in final reports
• Identify report inconsistencies and contact peer reviewers for clarification, modification, or correction
• Assist with customer complaints and quality assurance issues
• Ensure compliance with federal ERISA and state mandates
• Provide management insight on consultant quality, availability, and compliance
• Promote efficient utilization of company resources
• Participate in educational and training activities
• Perform other duties as assigned