Job Description
Note:
The job is a remote job and is open to candidates in USA. MCMC Services, LLC is hiring a Quality Assurance Coordinator to join their remote team. In this role, you will be responsible for ensuring the accuracy of medical reports, grammar, and content to uphold the highest standards of quality and care. Responsibilities Perform quality assurance review of 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 Ensure 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 Ensure 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 Verify that the peer reviewer has attested to only the facts and that no evidence of reviewer conflict of interest exists Ensure the provider credentials and signature are adhered to the final report Identify any inconsistencies within the report and contact the Provider to obtain clarification, modification or correction as needed Assist in resolution of customer complaints and quality assurance issues as needed Ensure all federal ERISA and/or state mandates are adhered to at all times Provide 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 Skills Medical Assistant or Certified Nursing Assistant experience Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbers and decimals; Ability to compute rates and percentages 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 bolthires 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 Must demonstrate accuracy and thoroughness.
Look 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 Must be able to demonstrate and promote a positive team -oriented environment Must be a qualified typist with a minimum of 40 W.P.M preferred Benefits Medical Vision Dental Paid time off 401k Company Overview MCMC’s Independent Peer Review program compliments your appeal, claims, prior-auth, utilization, and case management programs by providing the comprehensive physician expertise and driven service delivery you need to meet industry and regulatory standards for medical review.
It was founded in 1988, and is headquartered in Quincy, Massachusetts, USA, with a workforce of 501-1000 employees. Its website is