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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 - Wisconsin Remote

Review peer-review reports for clinical accuracy, regulatory compliance, and documentation quality in this remote ExamWorks role based in Wisconsin.

USUnited StatesWIWisconsin
$30 / hour
RemoteFull-timeJuniorMiddleEnglish RequiredQA Engineer

Description

  • Review peer-review reports, correspondence, addenda, and supplemental reviews for quality
  • Ensure recommendations and determinations are supported by clear, concise, evidence-based rationales
  • Confirm that client instructions, specifications, questions, clinical citations, and references are fully addressed
  • Check reports against company standards for content, formatting, presentation, and regulatory compliance
  • Verify that reviews are completed by the appropriate board-certified specialty and documented accurately
  • Validate peer reviewer attestations, conflict-of-interest status, credentials, and signatures
  • Identify report discrepancies and contact peer reviewers to request clarification, revisions, or corrections
  • Support the resolution of customer complaints and other quality assurance matters
  • Maintain compliance with federal ERISA requirements and applicable state mandates
  • Provide management with observations about consultant quality, availability, and compliance
  • Support the efficient use of company resources
  • Take part in educational programs and training activities
  • Complete additional duties as assigned

Requirements

  • An active RN or LPN nursing license is required
  • Graduate from an accredited nursing program or equivalent related medical experience
  • Bachelor's degree preferred
  • At least two years of clinical or related experience, or an equivalent combination of education and experience
  • Strong understanding of medical terminology, anatomy and physiology, medications, and laboratory values
  • Ability to complete arithmetic calculations using whole numbers and decimals and calculate rates and percentages
  • Typing speed of at least 40 words per minute
  • Ability to use computers, fax machines, copiers, scanners, and telephones
  • Working knowledge of Microsoft Word, Outlook, Excel, and the Internet
  • Excellent command of English usage, grammar, punctuation, and style
  • Ability to follow instructions and accurately act on management direction
  • Consistent accuracy and attention to detail
  • Exceptional written and verbal communication skills
  • Ability to work independently, prioritize tasks, and manage time effectively
  • Ability to protect confidential information

Benefits

  • Fully remote work arrangement
  • Medical, vision, and dental coverage
  • Paid time off
  • 401(k) plan
  • Fast-paced team environment

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