Quality Assurance Coordinator

Are You a Medical Assistant Ready to Break Free from the Office and Go Remote? If you're a Medical Assistant looking to make a career shift from the traditional office setting to a remote role, we've got an exciting opportunity just for you! MES is seeking a Quality Assurance Coordinator to join our team. In this role, you'll ensure medical reports are spot-on by reviewing for errors in grammar, medical terminology, and content accuracy. Your sharp attention to detail will be crucial in maintaining the highest standards of quality. Why You'll Love This Job: 100% remote—work from home where you're most comfortable! Monday through Friday 2 days 9-5:30 PM ET and 3 days 12-8:30 PM ET. Perfect for those seeking a consistent routine with occasional flexibility. Employee-first culture with great benefits —because we believe in investing in YOU! Duties and Responsibilities: Performs quality assurance review of medical 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 Provider 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.

MES Solutions, a respected pioneer of the independent medical examination (IME) and peer review services industry, is setting the standard for independent review services nationwide. We handle evaluations for a variety of property and casualty insurers, self-insureds and third-party administrator's business lines such as: automotive, disability, liability, group health, long-term care, FMLA and workers' compensation. IME and Peer Review services play an important role in evaluating the appropriateness, medical necessity, cost, as well as certification of requests for care. IME services and Peer Review services are provided by MES Solutions, accredited by URAC for CORE Organizational Quality, and MES Peer Review Services, a URAC accredited Comprehensive Independent Review Organization,­ respectively.