Clinical Quality Assurance Coordinator

MES Solutions

Clinical Quality Assurance Coordinator ensuring quality and integrity of case reports. Handling quality assurance questions and supporting the Quality Assurance Department.

Posted 6/30/2026full-timeRemote • Massachusetts • 🇺🇸 United StatesJuniorMid-Level💰 $30 - $31 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in quality assurance processes, ensuring compliance with HIPAA regulations and maintaining high standards in case report integrity. Proficient in medical terminology and claims management within the insurance industry.

Highest-signal resume keywords

Quality Assurance ReviewMedical Terminology KnowledgeHIPAA ComplianceClaims Management KnowledgeTyping Proficiency (40 W.P.M.)

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Quality AssuranceMedical TerminologyAnatomy and PhysiologyLaboratory ValuesClaims ManagementTyping (40 W.P.M.)

Soft Skills

Attention to DetailProblem SolvingCommunication

Tools & Technologies

Microsoft WordMicrosoft OutlookMicrosoft ExcelGeneral Computer Operation

Industry Keywords

Insurance IndustryPeer ReviewClient ComplaintsConfidentiality

About the role

Key responsibilities & impact

Responsible for ensuring case reports are of the highest quality and integrity.
Handle quality assurance questions and provide support to the Quality Assurance Department.
Perform quality assurance review of peer review reports, correspondences, addendums or supplemental reviews.
Ensure clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations.
Ensure that all client instructions and specifications have been followed and that all questions have been addressed.
Verify that the peer reviewer has attested to only the facts and that no evidence of reviewer conflict of interest exists.
Assist in resolution of client complaints and quality assurance issues as needed.

Requirements

What you’ll need

High school diploma or equivalent required.
Minimum of two (2) years of clinical or related experience preferred, or an equivalent combination of education and experience.
Knowledge of the insurance industry, including claims management (workers’ compensation, no-fault, liability, or disability), preferred.
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 have a full understanding of HIPAA regulations and compliance.
Must be able to operate a general computer, fax, copier, scanner, and telephone.
Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
Ability to follow instructions and respond to upper managements’ directions accurately.
Must be able to maintain confidentiality.

Benefits

Comp & perks

Health insurance
Professional development opportunities