IME RESOURCES LLC logo
IME RESOURCES LLC

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. Clients include property and casualty insurance carriers, law firms, third-party claim administrators, and government agencies. Services confirm the veracity of claims by sick or injured individuals under automotive, disability, liability, and workers' compensation insurance coverages.

Clinical Quality Assurance Coordinator - Supervisor

Location

United States

Posted

2 days ago

Salary

$85K - $90K / year

Seniority

Mid Level

Job Description

Clinical Quality Assurance Coordinator - Supervisor

IME RESOURCES LLC

Role Description The Clinical Quality Assurance Coordinator Supervisor is responsible for overseeing the daily workflow of the Quality Assurance Department and providing leadership and direction to ensure operations run as efficiently and effectively as possible. This position requires a complete understanding of the duties outlined below. This is a 100% fully remote role with a schedule of: Monday - Friday 8-5pm ET or 9-6pm ET (set, available for occasional escalated issues evenings/weekends by phone). Essential Job Functions: - 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 with 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 to promote and achieve the most efficient operation possible. - Participate in various educational and/or training activities as required. - Perform other duties as assigned. Essential Supervisory Responsibilities: - Carrying out all responsibilities in accordance with the company’s standards, policies, and all applicable employment laws. - Managing and monitoring workflow and providing support, training, and techniques to assist staff in achieving department daily/weekly/monthly goals and standards. - Encouraging positive morale, maintaining harmony among staff, and resolving grievances when necessary. - Overseeing the completion and approval of employee timecards and coordinating overtime needs with management and staff as needed. - Actively participating in the department’s staffing requirements including hiring, onboarding, and separating employees. - In conjunction with management, creating and implementing a plan to meet department’s goals and metrics based on workload and client needs. - Communicating change effectively and supporting those affected by change. - Supervising insubordinate staff when warranted and initiating coaching or corrective actions as required and/or directed by upper management. - Evaluating staff needs and performance, providing periodic feedback to staff and reporting any performance concerns and/or recommendations for growth opportunities to management. - Actively participating and successfully conducting annual performance evaluations. 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. - 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 and direct change, delays, or unexpected events appropriately. - Ability to follow all company policies and procedures in effect at the 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. Company Description MES Solutions is a premier provider of independent medical examination and peer review services to the insurance, corporate, legal, and government sectors. Members of our credentialed medical panel conduct physical examinations or medical record reviews, delivering reports that assist clients in the resolution of automotive, disability, liability, and workers' compensation claims. MES has been providing services nationally since 1978 in accordance with the industry's highest standards of operating excellence and regulatory compliance.

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