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Quality Assurance Specialist
2 months ago
Position Overview:
Are you a Medical Assistant (MA) or Certified Nursing Assistant (CNA) seeking a transition from a clinical environment to a remote role?
If so, MES Solutions, Inc. is in search of a Quality Assurance Specialist to join our dedicated team.
Your primary responsibility will be to meticulously review medical documentation, ensuring precision by identifying any discrepancies in grammar, medical terminology, and content prior to distribution to our clients.
This role is entirely remote, with a flexible schedule from Monday to Friday, allowing you to commence your workday anytime between 7:00 AM and 9:00 AM, concluding between 3:30 PM and 5:30 PM EST.Are you interested in being part of a company that prioritizes its employees and offers excellent benefits and career advancement opportunities? If this resonates with your career aspirations, we encourage you to consider this opportunity.
Key Responsibilities:
Conduct thorough quality assurance evaluations of medical reports, correspondence, addendums, or supplementary reviews.
Ensure that clear, concise, and evidence-based rationales are provided to support all recommendations and determinations.
Verify adherence to all client instructions and specifications, ensuring all inquiries have been addressed.
Confirm that each review is backed by clinical citations and references when applicable, ensuring all cited references are current and sourced from reputable medical journals or publications.
Maintain the content, format, and professional presentation of reports to meet the highest quality standards and comply with company policies.
Ensure that the appropriate board specialty has reviewed the case in accordance with client specifications and state mandates, documenting this accurately in the case report.
Verify that the peer reviewer has attested solely to the facts, ensuring no evidence of conflict of interest exists.
Identify any inconsistencies within the report and reach out to the Provider for clarification, modifications, or corrections as necessary.
Assist in resolving customer complaints and quality assurance issues as required.
Ensure compliance with all federal ERISA and state mandates at all times.
Provide insights and guidance to management regarding consultant quality, availability, and adherence to company policies and client specifications.
Engage in various educational and training activities as needed.
Perform additional duties as assigned.
Qualifications:
High school diploma or equivalent is required.
Strong knowledge of medical terminology, anatomy and physiology, medications, and laboratory values is essential.
Proficient typing skills with a minimum of 40 W.P.M preferred.
Familiarity with various software applications, including but not limited to Microsoft Word, Outlook, Excel, and the Internet is necessary.
Excellent command of English language usage, grammar, punctuation, and style is required.
Ability to follow instructions and accurately respond to management directives.
Demonstrate accuracy and thoroughness in all tasks.
Exceptional communication skills are essential, including the ability to convey information accurately, listen effectively, and ask clarifying questions when needed.
Ability to work independently, prioritize tasks, and manage time efficiently.
Maintain confidentiality at all times.
Ability to concentrate and stay focused amidst normal or heavy distractions.
Capable of working effectively under pressure and in stressful situations.
Ability to adapt to changes, delays, or unexpected events appropriately.
Demonstrate reliability and adhere to the company attendance policy.
MES Solutions, Inc. is a leading provider of independent medical examination and peer review services, catering to the insurance, corporate, legal, and government sectors.
Our credentialed medical panel conducts physical examinations or medical record reviews, delivering reports that assist clients in resolving automotive, disability, liability, and workers' compensation claims.
Since 1978, MES has been committed to delivering services nationally while adhering to the highest standards of operational excellence and regulatory compliance.
MES Solutions, Inc. offers a dynamic team environment with competitive benefits, including medical, vision, dental, paid time off, and a 401k plan.
We are an Equal Opportunity Employer, providing equal opportunities 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.
