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ExamWorks
ExamWorks
5,001 – 10,000 Employees
ConsultingHealthcareLegal

ExamWorks operates at the intersection of healthcare, consulting, and legal services, providing independent medical examinations and peer reviews for claims and related processes. Its work also includes bill reviews, Medicare compliance, medical-record and document management, and compliance auditing.

The company supports a broad physician network and develops enterprise platforms and workflow tools for healthcare organizations. Its teams combine clinical, operational, compliance, and technology expertise to help clients manage medical records and claims with greater consistency and reliability.

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Clinical Quality Assurance Coordinator — Massachusetts Remote

Review clinical peer-review documentation for MES, a provider of medical examination and peer-review services. Support evidence-based quality, regulatory compliance, and accurate reporting.

USUnited StatesMAMassachusetts
$27 – $29 / hour
RemoteFull-timeJuniorMiddleEnglish RequiredQA Engineer

Description

  • Conduct quality assurance reviews of peer-review reports, correspondence, addenda, and supplemental reviews.
  • Confirm that recommendations and determinations are supported by clear, concise, evidence-based rationales.
  • Check that client instructions, specifications, and questions have been fully addressed.
  • Validate that clinical citations are current and sourced from reputable medical publications.
  • Ensure reports meet company standards for content, formatting, and professional presentation.
  • Confirm the appropriate board specialty conducted the review and that documentation is accurate.
  • Verify peer-reviewer attestations and the absence of conflicts of interest.
  • Ensure final reports contain provider credentials and signatures.
  • Resolve report inconsistencies by contacting peer reviewers for clarification or corrections.
  • Support the handling of customer complaints and quality assurance concerns.
  • Maintain compliance with federal ERISA requirements and state mandates.
  • Provide management with insight into consultant quality, availability, and compliance.
  • Support effective and efficient use of company resources.
  • Complete required education and training activities.
  • Carry out other assigned responsibilities.

Requirements

  • Hold an active RN or LPN nursing license.
  • Graduate from an accredited nursing program or possess related medical experience.
  • A bachelor’s degree is preferred.
  • Have at least two years of clinical or related experience, or an equivalent combination of education and experience.
  • Demonstrate strong knowledge of medical terminology, anatomy and physiology, medications, and laboratory values.
  • Perform arithmetic calculations involving whole numbers, decimals, rates, and percentages.
  • Type at least 40 words per minute.
  • Operate computers, fax machines, copiers, scanners, and telephones.
  • Use Microsoft Word, Outlook, Excel, and the Internet.
  • Demonstrate excellent English usage, grammar, punctuation, and writing style.
  • Follow instructions and accurately respond to management direction.
  • Work independently, prioritize tasks, and manage time efficiently.
  • Maintain confidentiality.

Benefits

  • Medical, vision, and dental benefits are available.
  • Paid time off.
  • 401(k) plan.

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