ExamWorks

Role Description Are you a detail‑oriented professional who thrives on delivering exceptional customer service while keeping operations running smoothly? Join us as a Client Coordinator, where you will play a key role in managing client inquiries, supporting case workflow, and ensuring high‑quality documentation across multiple departments. The Client Coordinator is responsible for servicing inquiries from clients, physicians, nurses, or any representative acting on behalf of a client. This position is responsible for data preparation, data entry, data tracking, documentation, and filing. All duties are handled with a high degree of quality customer service and in compliance with all regulatory and company standards. Hours: Monday-Friday 10am-7:30pm CST Location: Remote Qualifications - High school diploma or equivalent required. - Minimum one-year clerical experience; or equivalent combination of education and experience preferred. - Experience in a medical office or insurance industry preferred. - No specific certificates, licenses, or registrations required. Requirements - Handle and respond promptly to inquiries from clients and/or anyone acting on behalf of the client regarding questions, report status, concerns, or general requests for information. - Utilize appropriate systems and databases to enter client or claimant information and/or retrieve information. - Maintain daily contact with the QA department regarding workflow and pending report status. - Contact providers for assignment and update database. - File and archive open and closed cases. - Verify all client information is current in the database and all client specific guidelines and/or rules or information is documented in the system. - Work independently and in partnership with other team members to ensure that questions are addressed, documented, and cases are returned in a timely fashion. - Direct calls to other departments as needed. - Perform various clerical duties such as typing, filing, emailing, and proofreading. - Assist in resolution of customer complaints and quality assurance issues. - Notify management of any report issues or concerns. - Ensure all practices are carried out in accordance with state and federal safety and legal regulations. - Perform other duties as assigned. Benefits - Extended hours are occasionally required beyond the regular eight (8) hour work day. - The noise level in the work environment is usually moderate. Company Description Examworks offers our vendors a vast network of providers who perform Compensation and Pension (C&P) exams, Separation Health Assessments (SHAs), and Reserve Health Readiness Program (RHRP) evaluations for our Nation's Veterans. Our offices are outfitted with state-of-the-art equipment and highly skilled medical professionals. We pride ourselves on delivering quality services in a timely manner. Examworks is an Equal Opportunity Employer and affords equal opportunity to all qualified applicants for all positions without regard to protected veteran status, qualified individuals with disabilities, and all individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, or any other status protected under local, state, or federal laws.

Role Description Are you a nurse leader passionate about quality, compliance, and driving meaningful outcomes? ExamWorks is looking for a Clinical Quality Assurance Supervisor to lead a Clinical Quality Assurance team in a fully remote environment. In this role, you’ll combine your clinical expertise with leadership skills to elevate quality standards, guide a dynamic team, and ensure evidence-based decision-making that directly impacts patient care and client satisfaction. Responsibilities - Coordinate and direct the QA department’s daily workflow to ensure all product lines are completed with the highest level of quality in the most effective and efficient manner possible. - Prioritize and manage the daily workload and ensure the appropriate and equitable distribution of work is maintained in order to achieve goals. - Monitor work product to ensure clear, concise, evidence-based rationales have been provided in support of all recommendations or determinations and that specific indicators and criteria in accordance with company policy and procedures have been achieved. - Ensure department compliance of all federal ERISA and state mandates is adhered to at all times. - Promote effective and efficient utilization of all clinical resources and make necessary recommendations for improvements to management as needed. - Ensure all client relationships are maintained and all client specific requirements are met. - Assist promptly in resolution of any physician and/or customer complaints or quality assurance issues. - Delegate work as needed and provide backup to all departmental positions as required. - Provide insight and direction to management on consultant quality, availability and compliance with all company policies and procedures. - Participate in the development and implementation of policies and procedures in order to promote and achieve the most efficient operation possible. - Participate in various educational and/or training activities as required. - Perform other duties as assigned. Qualifications - High school diploma or equivalent required. - A minimum of three years related experience; or equivalent combination of education and experience preferred. - Knowledge of the insurance industry, preferably claims management relative to workers' compensation, no-fault, liability, and disability is preferred. - Previous supervisory experience preferred. - Must possess a working knowledge of medical legal aspects of medical records and health information principles and/or liability. - Must possess complete knowledge of general computer, fax, copier, scanner, and telephone. - Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Excel, and the Internet. - Must be a qualified typist with a minimum of 40 W.P.M. - Must demonstrate exceptional communication skills. - Analyzes problems involving multiple interrelated causes. - Gathers information and applies complex concepts or methods to generate an effective solution. - Ability to follow instructions and respond to upper management’s directions accurately. - Must demonstrate accuracy, thoroughness, and responsibility for quality of work, and ability to take initiative to identify improvements. - Must be able to work independently, prioritize work activities and use time efficiently. - Must be able to take independent actions and calculated risks when needed. - Must use good judgment and include the appropriate people in the decision-making process. - Must be able to maintain confidentiality. - Must be able to demonstrate and promote a positive team-oriented environment. Benefits - 100% Remote – work from home, where you're most comfortable. - Consistent Schedule – weekdays with minimal weekend coverage. - Meaningful Impact – help shape quality standards and clinical outcomes. - Leadership Growth – expand your influence and advance your career. Company Description ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages. ExamWorks, LLC is an Equal Opportunity Employer and affords equal opportunity to all qualified applicants for all positions without regard to protected veteran status, qualified individuals with disabilities and all individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age or any other status protected under local, state or federal laws. ExamWorks offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.

Role Description If you're already a Paralegal in the claim's world looking to supercharge your career in a fast-paced, dynamic environment, then we've got an exciting opportunity for you! ExamWorks is looking for a Client Coordinator to join our team! The Client Coordinator is responsible for servicing inquiries from clients, physicians, nurses or any representative acting on behalf of a client. This position is responsible for: - Data preparation - Data entry - Data tracking - Documentation and filing All duties are handled with a high degree of quality customer service and in compliance with all regulatory and company standards. The role is 100% remote, Monday to Friday 8:30am-5:00pm EST. Qualifications - High school diploma or equivalent required. - Minimum one year clerical experience; or equivalent combination of education and experience preferred. - Experience in a medical office or insurance industry preferred. - Paralegal experience preferred. Requirements - Must possess complete knowledge of 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. - Must have ability to be trained on and adhere to HIPAA regulations and compliance standards. - Must be a qualified typist with a minimum of 40 W.P.M. - Ability to follow instructions and respond to management’s directions accurately. - Must demonstrate accuracy, thoroughness, and responsibility for quality of work, and ability to take initiative to identify improvements. - Must demonstrate exceptional communication skills. - Must be able to work independently, prioritize work activities and use time efficiently. - Must be able to maintain confidentiality. - Must be able to stay focused and concentrate under normal or heavy distractions. - Must be able to work well under pressure and/or stressful conditions. - Must possess the ability to manage change, delays, or unexpected events appropriately. - Ability to follow all company policies and procedures in effect at time of hire and as they may change or be added from time to time. Benefits - Competitive benefits (medical, vision, dental) - Paid time off - 401k

Role Description Are you a Medical Assistant looking to break free from the traditional office setting? If you're craving a fresh career path, this opportunity is tailor-made for you! ExamWorks is hiring a Quality Assurance Coordinator to join our remote team. In this role, you’ll be the final checkpoint for medical reports - ensuring accuracy in grammar, medical terminology, and content. Your keen eye for detail will help uphold the highest standards of quality and care. This position is 100% remote with your choice of: - 3 - 12 hour shifts, Friday-Sunday 7:00am-7:30pm CST - 4 - 10 hour shifts, Wednesday-Saturday 9:30am-7:00pm CST Responsibilities may include: - 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. If you're ready to bring your clinical expertise into a remote setting and make a meaningful impact behind the scenes, we want to hear from you! Qualifications - 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 a qualified typist with a minimum of 40 W.P.M preferred. - 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. - 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. Benefits - Competitive benefits (medical, vision, dental) - Paid time off - 401k Company Description ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages. ExamWorks, LLC is an Equal Opportunity Employer and affords equal opportunity to all qualified applicants for all positions without regard to protected veteran status, qualified individuals with disabilities and all individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age or any other status protected under local, state or federal laws.

Role Description Are you a Nurse (LPN, LVN or RN) seeking a role that challenges you, helps you grow, and lets you work from the comfort of your own home? ExamWorks has the perfect opportunity for you! We’re looking for a Clinical Quality Assurance Coordinator to join our team! In this role, you’ll ensure Peer Review case reports meet the highest standards of quality, integrity, and compliance with client agreements, regulatory guidelines, and federal/state mandates. Why This Role Rocks: - 100% Remote - Enjoy the flexibility of working from home! - Impactful Work - You’ll play a key role in ensuring the quality and compliance of critical reports. - Schedule - Monday to Friday; 8:30am-5:00pm EST Responsibilities may include: - 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. - 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 the appropriate board specialty has reviewed the case in compliance with client specifications 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 contacts the Peer Reviewer to obtain clarification, modification or correction as needed. - Assist in resolution of client complaints and quality assurance issues as needed. - Ensure all federal ERISA and 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. Qualifications - High school diploma or equivalent required with a minimum of two years clinical or related field experience; or equivalent combination of education and experience. - Experience in peer review, clinical documentation review, or medical necessity assessments. - Familiarity with CMS guidelines, InterQual, Milliman/MCG, or payer policies. - Prior employment with insurance carriers, TPAs, or managed care organizations. - 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 a qualified typist with a minimum of 40 W.P.M. - 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. - Must possess excellent skills in English usage, grammar, punctuation and style. - Ability to follow instructions and respond to upper managements’ directions accurately. - Demonstrates accuracy and thoroughness. Looks 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. Benefits - Competitive benefits (medical, vision, dental) - Paid time off - 401k

Job DetailsJob Location: Rockford, IL 61108Position Type: Full TimeSalary Range: $45.00 - $52.00 HourlyAre you passionate about clinical quality, accuracy, and continuous improvement -and looking for a role that allows you to make a meaningful impact while working from home? We’re seeking a Utilization Review & Quality Assurance Specialist to join our fully remote team. This role offers a consistent 8:00am-4:30pm EST schedule, providing structure and work-life balance while you contribute to high‑quality clinical review operations. In this role, you’ll be at the center of ensuring excellence - leveraging strong knowledge of group health plans, clinical criteria sets, leadership, and change management to review clinical documentation, uphold regulatory and client standards, and drive quality across medical review processes. Responsibilities may include: Evaluate clinical information received, write and/or review various reports including, but not limited to: Medical Record Reviews, Medical Record Chronologies, Provider Bill Reviews, Coding Reviews, Hospital Bill Reviews, List of Missing Records, Medical Bill Apportionments, Mock Billing Invoice and Medical Summary Statements. Perform quality assurance reviews of peer review reports, correspondences, addendums or supplemental reviews to ensure they meet company standards for content, clarity, evidence-based rationale, formatting, and professional presentation. Ensure all client instructions and specifications have been followed, all questions have been answered, and all recommendations or determinations are supported by clear, concise, and evidence-based rationales. Verify that each review includes appropriate clinical citations when applicable, and ensure all references cited are current and obtained from reputable medical journals and publications. Identify inconsistencies within reports and contact the reviewer to obtain clarifications, modifications, or corrections needed. Assist in the resolution of customer complaints and quality assurance issues as appropriate. Ensure all federal ERISA and applicable state mandates are adhered to. Provide ongoing feedback and recommendations to management regarding consultant performance, quality trends, and compliance with internal and client specific requirements. Participate in the development and implementation of policies and procedures to improve efficiency and quality across operations. Develop and lead formal and informal training sessions -individually or in groups -that promote high-quality utilization review practices and reinforce company standards. Develop and document new or improved operational processes to support continuous improvement. Promote effective and efficient utilization of company resources across all responsibilities. Participate in or lead various continuing education and training activities related to clinical knowledge, industry standards, and company processes. Perform other duties as assigned. Qualifications Must hold and maintain a Registered Nursing License. Strong knowledge of group health/criteria sets/leadership/change management. Must have strong understanding of medical terminology, anatomy and physiology, treatment protocols, medications and laboratory values. Must be proficient in Microsoft Office Suite, Outlook, internet navigation and general office equipment. Must have the ability to follow instructions and respond to upper managements’ directions accurately. Ability to work independently, prioritize tasks, and manage time efficiently in a fast-paced environment. Ability to demonstrate accuracy, thoroughness, and commitment to producing high quality work; actively monitor own performance and seek opportunities for improvement. Ability to demonstrate flexibility and remain composed under pressure or in stressful conditions; adapts well to change and promotes a positive team environment. Must be able to maintain confidentiality. Ability to follow all company policies and procedures in effect at time of hire and as they may change or be added from time to time. ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages. Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws. Equal Opportunity Employer - Minorities/Females/Disabled/Veterans ExamWorks offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.

Job DetailsJob Location: Tampa, FL 33619Position Type: Full TimeSalary Range: $22.00 - $26.00 HourlyTravel Percentage: NoneAre You a Florida‑Based Paralegal in the Claims World? Applicants must currently reside in Florida or have litigation experience in Florida to be considered. If you're already a Paralegal in the claim's world looking to supercharge your career in a fast-paced, dynamic environment, then we've got an exciting opportunity for you! ExamWorks is looking for a Client Coordinator to join our team! The Client Coordinator is responsible for servicing inquiries from clients, physicians, nurses or any representative acting on behalf of a client. This position is responsible for data preparation, data entry, data tracking, documentation and filing. All duties are handled with a high degree of quality customer service and in compliance with all regulatory and company standards. The role is 100% remote, Monday to Friday 8:30am-5:00pm EST. ESSENTIAL JOB FUNCTIONS Handle and respond promptly to inquiries from clients and/or anyone acting on behalf of the client regarding questions, report status, concerns, or general requests for information. Utilize appropriate systems and databases to enter client or claimant information and or retrieve information. Maintain daily contact with the QA department regarding workflow and pending report status. Contact providers for assignment and update database. File and archive open and closed cases. Verify all client information is current in the database and all client specific guidelines and or rules or information is documented in the system. Work independently and in partnership with other team members to ensure that questions are addressed, documented and cases are returned in a timely fashion. Direct calls to other departments as needed. Perform various clerical duties such as typing, filing, emailing, and proofreading. Assist in resolution of customer complaints and quality assurance issue. Notify management of any report issues or concerns. Ensure all practices are carried out in accordance with state and federal safety and legal regulations. Perform other duties as assigned. QualificationsEducation and/or Experience High school diploma or equivalent required. Minimum one year clerical experience; or equivalent combination of education and experience preferred. Experience in a medical office or insurance industry preferred. Paralegal experience preferred. QUALIFICATIONS Must possess complete knowledge of 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. Must have ability to be trained on and adhere to HIPAA regulations and compliance standards. Must be a qualified typist with a minimum of 40 W.P.M. Ability to follow instructions and respond to managements’ directions accurately. Must demonstrate accuracy, thoroughness, and responsibility for quality of work, and ability to take initiative to identify improvements. Looks for ways to improve and promote quality and monitors own work to ensure quality is met. Must demonstrate exceptional communication skills. Must be able to work independently, prioritize work activities and use time efficiently. Must be able to maintain confidentiality. Must be able to stay focused and concentrate under normal or heavy distractions. Must be able to work well under pressure and or stressful conditions. Must possess the ability to manage change, delays, or unexpected events appropriately. Ability to follow all company policies and procedures in effect at time of hire and as they may change or be added from time to time. ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages. ExamWorks, LLC is an Equal Opportunity Employer and affords equal opportunity to all qualified applicants for all positions without regard to protected veteran status, qualified individuals with disabilities and all individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age or any other status protected under local, state or federal laws. ExamWorks offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.

Job DetailsJob Location: Mount Laurel, NJ 08054Position Type: Full TimeSalary Range: $18.00 - $20.00 HourlyTravel Percentage: NoneWe're looking for a Remote Client Coordinator to join our team! The Client Coordinator is responsible for servicing inquiries from clients, physicians, nurses or any representative acting on behalf of a client. This position is responsible for data preparation, data entry, data tracking, documentation and filing. All duties are handled with a high degree of quality customer service and in compliance with all regulatory and company standards. Role Highlights: Full-time position: Monday-Friday, 8am to 5pm EST Competitive pay: $18 to $20 per hour Location: Fully Remote! Duties & Responsibilities include: Handle and respond promptly to inquiries from clients and/or anyone acting on behalf of the client regarding questions, report status, concerns, or general requests for information. Utilize appropriate systems and databases to enter client or claimant information and or retrieve information. Maintain daily contact with the QA department regarding workflow and pending report status. Contact providers for assignment and update database. File and archive open and closed cases. Verify all client information is current in the database and all client specific guidelines and or rules or information is documented in the system. Work independently and in partnership with other team members to ensure that questions are addressed, documented and cases are returned in a timely fashion. Direct calls to other departments as needed. Perform various clerical duties such as typing, filing, emailing, and proofreading. Assist in resolution of customer complaints and quality assurance issue. Notify management of any report issues or concerns. Ensure all practices are carried out in accordance with state and federal safety and legal regulations. Perform other duties as assigned. QualificationsEducation and/or Experience High school diploma or equivalent required. Minimum one year clerical experience; or equivalent combination of education and experience preferred. Experience in a medical office or insurance industry preferred. QUALIFICATIONS Must possess complete knowledge of 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. Must have ability to be trained on and adhere to HIPAA regulations and compliance standards. Must be a qualified typist with a minimum of 40 W.P.M. Ability to follow instructions and respond to managements’ directions accurately. Must demonstrate accuracy, thoroughness, and responsibility for quality of work, and ability to take initiative to identify improvements. Looks for ways to improve and promote quality and monitors own work to ensure quality is met. Must demonstrate exceptional communication skills. 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 able to stay focused and concentrate under normal or heavy distractions. Must be able to work well under pressure and or stressful conditions. Must possess the ability to manage change, delays, or unexpected events appropriately. Ability to follow all company policies and procedures in effect at time of hire and as they may change or be added from time to time. ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages. ExamWorks offers a fast-paced team atmosphere with competitive benefits, paid time off, and 401k. ExamWorks, LLC is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws. Equal Opportunity Employer - Minorities/Females/Disabled/Veterans

Job DetailsJob Location: Southfield, MI 48076Position Type: Full TimeSalary Range: $25.00 - $28.00 HourlyCraving a New Adventure? Flex Your Clinical Skills Right from Your Couch! Are you a Nurse (LPN, LVN or RN) seeking a role that challenges you, helps you grow, and lets you work from the comfort of your own home? ExamWorks has the perfect opportunity for you! We’re looking for a Clinical Quality Assurance Coordinator to join our team! In this role, you’ll ensure Peer Review case reports meet the highest standards of quality, integrity, and compliance with client agreements, regulatory guidelines, and federal/state mandates. Why This Role Rocks: 100% Remote - Enjoy the flexibility of working from home! Impactful Work - You’ll play a key role in ensuring the quality and compliance of critical reports. Schedule - 8:30am-5:00pm EST Responsibilities may include: 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. 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 the appropriate board specialty has reviewed the case in compliance with client specifications 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 contacts the Peer Reviewer to obtain clarification, modification or correction as needed. Assist in resolution of client complaints and quality assurance issues as needed. Ensure all federal ERISA and 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. Qualifications High school diploma or equivalent required with a minimum of two years clinical or related field experience; or equivalent combination of education and experience. Experience in peer review, clinical documentation review, or medical necessity assessments. Familiarity with CMS guidelines, InterQual, Milliman/MCG, or payer policies. Prior employment with insurance carriers, TPAs, or managed care organizations. 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 a qualified typist with a minimum of 40 W.P.M 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. Must possess excellent skills in English usage, grammar, punctuation and style. Ability to follow instructions and respond to upper managements’ directions accurately. Demonstrates accuracy and thoroughness. Looks 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. ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages. Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws. Equal Opportunity Employer - Minorities/Females/Disabled/Veterans ExamWorks offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.

Job DetailsJob Location: Rockford, IL 61108Position Type: Full TimeSalary Range: $26.50 - $28.50 HourlyTravel Percentage: NoneCraving a New Adventure? Flex Your Clinical Skills Right from Your Couch! Are you a Nurse (LPN, LVN or RN) seeking a role that challenges you, helps you grow, and lets you work from the comfort of your own home? ExamWorks has the perfect opportunity for you! We’re looking for a Clinical Quality Assurance Coordinator to join our team! In this role, you’ll ensure Peer Review case reports meet the highest standards of quality, integrity, and compliance with client agreements, regulatory guidelines, and federal/state mandates. Why This Role Rocks: 100% Remote - Enjoy the flexibility of working from home! Impactful Work - You’ll play a key role in ensuring the quality and compliance of critical reports. Schedule - 9:30am-6:00pm CT, either Wednesday-Sunday or Monday and Wednesday-Saturday (some flexibility); Monday-Friday with weekend rotations may also be an option! Responsibilities may include: 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. 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 the appropriate board specialty has reviewed the case in compliance with client specifications 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 contacts the Peer Reviewer to obtain clarification, modification or correction as needed. Assist in resolution of client complaints and quality assurance issues as needed. Ensure all federal ERISA and 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. QualificationsHigh school diploma or equivalent required. A minimum of two years clinical or related field experience; or equivalent combination of education and experience. Knowledge of the insurance industry preferably claims management relative to one or more of the following categories: workers' compensation, no-fault, liability, and/or disability. 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 a qualified typist with a minimum of 40 W.P.M 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. Must possess excellent skills in English usage, grammar, punctuation and style. Ability to follow instructions and respond to upper managements’ directions accurately. Demonstrates accuracy and thoroughness. Looks 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. ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages. Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws. Equal Opportunity Employer - Minorities/Females/Disabled/Veterans ExamWorks offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.