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MES Solutions
MES Solutions
201 – 500 Angajați
Asistență medicalăConsultanțăJuridic

MES Solutions sprijină comunitatea din domeniul daunelor și al gestionării riscurilor prin evaluări medicale independente, evaluări inter pares și servicii clinice și administrative conexe. Activitatea companiei include coordonarea examinărilor medicale independente, obținerea și analizarea dosarelor medicale, gestionarea acreditării medicilor și sprijinirea evaluărilor privind aptitudinea pentru muncă și dizabilitatea.

Compania deservește asigurători, administratori terți, angajatori autoasigurați, agenții guvernamentale și avocați din domeniile auto, dizabilității, răspunderii, compensațiilor pentru accidente de muncă și asigurărilor de sănătate de grup. MES Solutions pune, de asemenea, accent pe conformitatea cu HIPAA, HITECH și HITRUST, reunind expertiză medicală, juridică și de consultanță pentru organizațiile care au nevoie de opinii medicale independente în luarea deciziilor privind daunele și gestionarea riscurilor.

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Locurile de muncă ale companiei

Clinical Quality Assurance Coordinator - Remote in Massachusetts

MES Solutions is hiring a Clinical Quality Assurance Coordinator to review medical peer-review reports, validate evidence-based documentation, and support regulatory compliance. This full-time remote role serves Massachusetts-based operations.

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

Descriere

  • 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, and questions are fully addressed
  • Check that clinical citations and references are current and sourced from reputable medical publications
  • Verify that reports meet company standards for content, formatting, and professional presentation
  • Confirm reviews are assigned to the appropriate board specialty and documented accurately
  • Validate peer reviewer attestations and the absence of conflicts of interest
  • Ensure final reports include provider credentials and signatures
  • Identify inconsistencies and contact peer reviewers to request clarification or corrections
  • Support the resolution of customer complaints and quality assurance concerns
  • Maintain compliance with federal ERISA requirements and applicable state mandates
  • Provide management with information about consultant quality, availability, and compliance
  • Help promote efficient and effective use of company resources
  • Complete required educational and training activities
  • Carry out other duties assigned by management

Cerințe

  • An active RN or LPN nursing license is required
  • Graduation from an accredited nursing program or related medical experience is required
  • A bachelor's degree is preferred
  • At least two years of clinical or related experience, or an equivalent combination of education and experience
  • Strong knowledge of medical terminology, anatomy and physiology, medications, and laboratory values
  • Ability to perform calculations using whole numbers, decimals, rates, and percentages
  • Typing proficiency 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 communication skills
  • Ability to work independently, prioritize tasks, and manage time efficiently
  • Ability to protect confidential information

Beneficii

  • Medical insurance coverage
  • Vision insurance coverage
  • Dental insurance coverage
  • Paid time off
  • 401(k) plan
  • Fully remote work arrangement
  • Monday-through-Friday schedule

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