Clinical Quality Assurance Coordinator

MES Solutions

. Perform quality assurance review of peer review reports, correspondences, addendums, and supplemental reviews .

Posted 9/24/2026full-timeRemote • Massachusetts • United StatesJuniorMid-Level💰 $27 - $31 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in quality assurance processes, ensuring compliance with clinical standards and regulations while maintaining accurate documentation and effective communication. Proficient in medical terminology and capable of performing detailed reviews to support evidence-based recommendations.

Highest-signal resume keywords

Active RN Or LPN Nursing LicenseQuality Assurance ReviewMedical Terminology KnowledgeClinical ExperienceMicrosoft Office Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Quality Assurance ReviewMedical Terminology KnowledgeArithmetic CalculationsTyping Speed Of 40 W.P.M.Clinical ExperienceEvidence-Based RationalesReport FormattingProvider Credential VerificationPeer Reviewer Attestation VerificationCompliance With ERISA

Soft Skills

Exceptional Communication SkillsAbility To Work IndependentlyPrioritization SkillsAttention To DetailConfidentiality Maintenance

Tools & Technologies

Microsoft WordMicrosoft OutlookMicrosoft ExcelGeneral Computer OperationFax MachineCopierScannerTelephone

Certifications & Qualifications

Active RN Or LPN Nursing License

Industry Keywords

Clinical StandardsPeer Review ProcessFederal ERISA ComplianceState MandatesAccredited Nursing Program

About the role

Key responsibilities & impact

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

Requirements

What you’ll need

Active RN or LPN nursing license required
Must be a graduate of an accredited nursing program or have related medical experience
Bachelor's degree preferred
Minimum of two years clinical or related field experience, or equivalent combination of education and experience
Strong knowledge of medical terminology, anatomy and physiology, medications, and laboratory values
Ability to perform arithmetic calculations with whole numbers and decimals and compute rates and percentages
Qualified typist with a minimum of 40 W.P.M.
Ability to operate a general computer, fax, copier, scanner, and telephone
Knowledge of Microsoft Word, Outlook, Excel, and the Internet
Excellent English usage, grammar, punctuation, and style
Ability to follow instructions and respond accurately to upper management's directions
Demonstrated accuracy and thoroughness
Exceptional communication skills
Ability to work independently, prioritize work activities, and use time efficiently
Ability to maintain confidentiality

Benefits

Comp & perks

Fully remote work arrangement
Competitive benefits
Medical insurance
Vision insurance
Dental insurance
Paid time off
401k
No travel required