Licensed Clinical Quality Coordinator

Job Summary

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

Key Responsibilities

• Perform quality assurance reviews of peer review reports and ensure compliance with client specifications
• Verify that clinical citations are current and from reputable sources, and address any inconsistencies in reports
• Assist in resolving client complaints and provide insights on consultant quality and compliance

Required Qualifications

• High school diploma or equivalent with at least two years of clinical or related field experience
• Experience in peer review, clinical documentation review, or medical necessity assessments
• Familiarity with CMS guidelines and payer policies
• Strong knowledge of medical terminology, anatomy, and physiology
• Ability to operate various software programs, including Microsoft Word and Excel