Clinical Quality Assurance Coordinator

Are you a Nurse (RN, LPN or LVN) looking for an exciting new opportunity? ExamWorks is on the hunt for a talented Clinical Quality Assurance Coordinator to join our growing team! In this role, you’ll dive into medical records, pulling out key details and crafting detailed narrative summaries. Your keen eye for detail will make you an invaluable part of our quality assurance process.

Why You’ll Love This Role:
     -100% Remote – Work from where you're most comfortable - home!
     -Monday-Friday schedule.  Start your day between 7:00am and 9:00am CT, and end between 3:30pm and 5:30pm CT.
     -Great Training – Our training program is designed to set you up for success, with a preferred training schedule of 7:30am-4:00pm CT, Monday-Friday.

At ExamWorks, we’re an employee-first company offering fantastic benefits and incredible growth opportunities. If you’re ready to take the next step in your career with a team that values your expertise, we want to hear from you!

Don’t wait—apply today and join us on this exciting journey! 

• Write narrative summaries of medical records with the ability to read through medical records and type out pertinent information in narrative form.
• Ensures the content, format, and professional appearance of the summarized medical records are of the highest quality and in compliance with company standards.
• Performs quality assurance review of peer review reports, correspondences, addendums or supplemental reviews.
• Ensures clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations.
• Ensures that all client instructions and specifications have been followed and that all questions have been addressed.
• Ensures each review is supported by clinical citations and references when applicable and verifies that all references cited are current and obtained from reputable medical journals and/or publications.
• Ensures the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards.
• Ensure that the appropriate board specialty has reviewed the case in compliance with client specifications and/or state mandates and is documented accurately on the case report.
• Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists.
• Ensures the provider credentials and signature are adhered to the final report.
• Identifies any inconsistencies within the report and contacts the Peer Reviewer to obtain clarification, modification or correction as needed.
• Assists in resolution of customer complaints and quality assurance issues as needed.
• Ensures all federal ERISA and/or state mandates are adhered to at all times.
• Provides insight and direction to management on consultant quality, availability and compliance with all company policies and procedures and client specifications.
• Promote effective and efficient utilization of company resources.
• Participate in various educational and or training activities as required.
• Perform other duties as assigned.

• Must be a graduate of an accredited nursing program or related medical experience; bachelor's degree preferred.
• A minimum of two years clinical or related field experience; or equivalent combination of education and experience. 
• Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values.
• Must be a qualified typist with a minimum of 40 W.P.M
• Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
• Must possess excellent skills in English usage, grammar, punctuation and style.
• Ability to follow instructions and respond to upper managements’ directions accurately.
• Demonstrates accuracy and thoroughness. Looks for ways to improve and promote quality and monitors own work to ensure quality is met.
• Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed.
• Must be able to work independently, prioritize work activities and use time efficiently.
• Must be able to maintain confidentiality.

ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages.

ExamWorks, LLC is an Equal Opportunity Employer and affords equal opportunity to all qualified applicants for all positions without regard to protected veteran status, qualified individuals with disabilities and all individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age or any other status protected under local, state or federal laws.

ExamWorks offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.

Equal Opportunity Employer - Minorities/Females/Disabled/Veterans