Clinical Quality Assurance Coordinator

Job Summary

A company is looking for a Clinical Quality Assurance Coordinator to ensure the quality and compliance of peer review case reports.

Key Responsibilities

• Perform quality assurance review of peer review reports and ensure compliance with client specifications
• Verify that clinical citations are current and from reputable sources, and ensure reports meet company standards
• Assist in resolving client complaints and quality assurance issues as needed

Required Qualifications

• High school diploma or equivalent with a minimum of two years clinical or related field experience
• Experience in peer review, clinical documentation review, or medical necessity assessments
• Familiarity with CMS guidelines, InterQual, or payer policies
• Strong knowledge of medical terminology, anatomy, and physiology
• Ability to operate standard office equipment and utilize software programs such as Microsoft Word and Excel