Clinical Quality Assurance Nurse Auditor (32292)

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    "description": "<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Are you a <strong>Registered Nurse (RN) </strong>with&nbsp;<strong>Critical Care</strong> and ER experience<strong>&nbsp;</strong>looking to <em>move away from the bedside</em> while still utilizing your clinical skills at home?</span></span></p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\"><strong>ExamWorks</strong> is looking for <strong><u>detail-oriented</u></strong> and <strong><u>motivated</u></strong> candidates&nbsp; <strong>*REMOTE*</strong> Clinical Quality Assurance Nurse Auditor to join the team!</span></span></p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Schedule:: <strong>Monday-Friday&nbsp; 8am-5pm PST or CST</strong></span></span><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\"><strong> </strong>Pay range:<strong> $34 to $35</strong></span></span></p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">The Clinical Quality Assurance Nurse Auditor is responsible for evaluating clinical information received from hospital records. This position ensures reports are completed with highest quality and integrity and that all work is in full compliance with client contractual agreements, regulatory agency standards and/or federal and state mandates. This position is required to handle quality assurance questions and provide overall support to the Quality Assurance Department.</span></span></p>\n\n<p>&nbsp;</p>\n\n<ul>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Evaluates clinical information received, writes and/or reviews various reports including 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.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Performs quality assurance review of peer review reports, correspondences, addendums or supplemental reviews.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Ensures clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Ensures that all client instructions and specifications have been followed and that all questions have been addressed.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Ensures 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.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Ensures the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">In IME or Peer Review cases, ensures 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.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Ensures the provider credentials and signature are adhered to the final report.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Identifies any inconsistencies within the report and contacts the Peer Reviewer to obtain clarification, modification or correction as needed.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Contacts appropriate person to recover any missing documentation or verify charges.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Assists in resolution of customer complaints and quality assurance issues as needed.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Ensures all federal ERISA and/or state mandates are adhered to at all times.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Provides insight and direction to management on consultant quality, availability and compliance with all company policies and procedures and client specifications.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Promote effective and efficient utilization of company resources.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Participate in various continuing education requirements and or training activities</span></span></li>\n</ul>\n",
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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.\\n\\n&nbsp;\\n\\nExamWorks offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.\\n\\n&nbsp;\\n\\nEqual Opportunity Employer - Minorities/Females/Disabled/Veterans\\n\",\"experienceRequirements\":\"EDUCATION AND/OR EXPERIENCE\\n\\nBachelor degree in nursing or related field; or minimum five years related experience; or equivalent combination of education and experience. Experience with medical terminology, critical care,&nbsp; medical specialties and treatment protocols required.&nbsp;\\n\\n&nbsp;\\n\\nCERTIFICATES, LICENSES, REGISTRATIONS\\n\\nRegistered Nursing license required.\\n\\n&nbsp;\\n\\nQUALIFICATIONS&nbsp; \\n\\n\\n\\tMust hold and maintain an unencumbered Registered Nursing license.\\n\\tMust have experience in Emergency Room and Critical Care settings.\\n\\tMust have strong knowledge of medical terminology, anatomy and physiology, treatment protocols, medications and laboratory values.\\n\\tMust be able to add, subtract, multiply, and divide in all units of measure, using whole numbers and decimals; Ability to compute rates and percentages.\\n\\tMust be a qualified typist with a minimum of 40 W.P.M.\\n\\tMust be able to operate a general computer, fax, copier, scanner, and telephone.\\n\\tMust be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.\\n\\tMust possess excellent skills in English usage, grammar, punctuation and style.\\n\\tAbility to follow instructions and respond to upper managements&rsquo; directions accurately.\\n\\tDemonstrates accuracy and thoroughness. 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    "qualifications": "<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\"><strong>EDUCATION AND/OR EXPERIENCE</strong></span></span></p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Bachelor degree in nursing or related field; or minimum five years related experience; or equivalent combination of education and experience. Experience with medical terminology, critical care,&nbsp; medical specialties and treatment protocols required.&nbsp;</span></span></p>\n\n<p>&nbsp;</p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\"><strong>CERTIFICATES, LICENSES, REGISTRATIONS</strong></span></span></p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Registered Nursing license required.</span></span></p>\n\n<p>&nbsp;</p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\"><strong>QUALIFICATIONS&nbsp; </strong></span></span></p>\n\n<ul>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must hold and maintain an unencumbered Registered Nursing license.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must have experience in Emergency Room and Critical Care settings.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must have strong knowledge of medical terminology, anatomy and physiology, treatment protocols, medications and laboratory values.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">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.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must be a qualified typist with a minimum of 40 W.P.M.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must be able to operate a general computer, fax, copier, scanner, and telephone.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must possess excellent skills in English usage, grammar, punctuation and style.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Ability to follow instructions and respond to upper managements&rsquo; directions accurately.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Demonstrates accuracy and thoroughness. Looks for ways to improve and promote quality and monitors own work to ensure quality is met.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must be able to work independently, prioritize work activities and use time efficiently.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must be able to maintain confidentiality.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must be able to demonstrate and promote a positive team -oriented environment.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must be able to stay focused and concentrate with frequent interruptions.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must be able to work well under pressure and or stressful conditions.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must possess the ability to manage change, delays, or unexpected events appropriately.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Demonstrates reliability and abides by the company attendance policy.</span></span></li>\n\t<li><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Must maintain a professional and clean appearance at all times consistent with company standards.</span></span></li>\n</ul>\n\n<p>&nbsp;</p>\n\n<div style=\"text-align:center\">\n<hr /></div>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">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&#39; compensation insurance coverages.</span></span></p>\n\n<p>&nbsp;</p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">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.</span></span></p>\n\n<p>&nbsp;</p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">ExamWorks offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.</span></span></p>\n\n<p>&nbsp;</p>\n\n<p><span style=\"display:block; font-size:12px\"><span style=\"font-family:Arial,Helvetica,sans-serif\"><strong>Equal Opportunity Employer - Minorities/Females/Disabled/Veterans</strong></span></span></p>\n",
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