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ExamWorks
ExamWorks
5.001 – 10.000 Angajați
Asistență medicalăConsultanțăJuridic

ExamWorks activează la intersecția dintre domeniul medical, consultanță și servicii juridice, oferind examinări medicale independente și evaluări realizate de specialiști de același nivel pentru dosare de despăgubire și procese conexe. Activitatea sa include, de asemenea, verificarea facturilor, conformitatea cu cerințele Medicare, gestionarea dosarelor medicale și a documentelor, precum și audituri de conformitate.

Compania sprijină o rețea extinsă de medici și dezvoltă platforme pentru organizații și instrumente de gestionare a fluxurilor de lucru pentru organizații din domeniul medical. Echipele sale combină expertiza clinică, operațională, de conformitate și tehnologică pentru a ajuta clienții să gestioneze dosarele medicale și cererile de despăgubire cu mai multă consecvență și fiabilitate.

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Locurile de muncă ale companiei

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.

USStatele Unite ale AmericiiMAMassachusetts
27 $ – 29 $ / oră
RemoteNormă întreagăJuniorNivel mediuLimbă Obligatorie: englezăInginer QA

Descriere

  • 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.

Cerințe

  • 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.

Beneficii

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

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