Clinical Quality Assurance Coordinator

MES Solutions

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

Posted 10/31/2026full-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 federal ERISA and state mandates while maintaining high standards in report accuracy and documentation. Proficient in medical terminology and clinical practices, with strong communication skills to effectively address customer complaints and collaborate with peer reviewers.

Highest-signal resume keywords

Active RN/LPN Nursing LicenseQuality Assurance ReviewsMedical Terminology KnowledgeClinical ExperienceMicrosoft Office Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Quality AssuranceMedical TerminologyClinical ExperienceReport DocumentationData ComputationTyping Speed (40 W.P.M.)Anatomy and Physiology KnowledgeLaboratory Values KnowledgeEvidence-Based RationalesCompliance Verification

Soft Skills

Exceptional Communication SkillsAbility to Work IndependentlyPrioritization SkillsAttention to DetailConfidentiality Maintenance

Tools & Technologies

ComputerFax MachineCopierScannerTelephoneMicrosoft WordMicrosoft OutlookMicrosoft ExcelInternet

Certifications & Qualifications

Active RN/LPN Nursing License

Industry Keywords

ERISA CompliancePeer ReviewClinical CitationsProvider CredentialsCustomer ComplaintsHealthcare StandardsEvidence-Based PracticeBoard Specialty Review

About the role

Key responsibilities & impact

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, clinical citations, and current reputable references are followed
Ensure report content, format, appearance, and compliance meet company standards
Confirm appropriate board specialty review and accurate documentation
Verify peer reviewer attestations, absence of conflicts of interest, provider credentials, and signatures
Identify report inconsistencies and contact peer reviewers for clarification or corrections
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

Requirements

What you’ll need

Active RN/LPN nursing license required
Graduate of an accredited nursing program or related medical experience
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 compute using whole numbers and decimals, including rates and percentages
Qualified typist with a minimum of 40 W.P.M.
Ability to operate a 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 management directions
Accuracy and thoroughness
Exceptional communication skills
Ability to work independently, prioritize work, and use time efficiently
Ability to maintain confidentiality

Benefits

Comp & perks

Fully remote work
Medical, vision, and dental benefits
Paid time off
401k
Competitive benefits
Educational and training activities