Redding, California, United States · On-site
$34/hr–$35/hr
Job DetailsJob Location: Redding, CA 96002Position Type: Full TimeSalary Range: $34.00 - $35.00 HourlyTravel Percentage: None*** All candidates must reside in the Pacific Time Zone. You must also be a Registered Nurse (R…
Skills: Clinical Auditing, Medical Record Review, Medical Coding, Hospital Billing, ERISA Regulations
Columbus, Ohio, United States · On-site
$19/hr–$21/hr
Job DetailsJob Location: Dublin, OH 43017Position Type: Full TimeSalary Range: $19.50 - $21.00 HourlyTravel Percentage: NoneAre You a Scheduling Superstar? We’re looking for someone just like YOU! If you’re a…
Skills: Scheduling, Communication, Multitasking, Medical Office Administration, Time Management
Kendall, Florida, United States · On-site
$18/hr–$20/hr
Job DetailsJob Location: Miami, FL 33183Position Type: Full TimeSalary Range: $18.00 - $20.00 HourlyTravel Percentage: NoneExamWorks is looking for a Client Coordinator to join our team onsite! This role is ideal for som…
Skills: Customer Service, Phone Communication, Data Entry, Microsoft Word, Microsoft Excel
Sacramento, California, United States · On-site
$75k–$90k/yr
Job DetailsJob Location: Sacramento, CA 95825Position Type: Full TimeSalary Range: $75,000.00 - $90,000.00 Base+Commission/yearTravel Percentage: 75%SUMMARY The Account Executive is responsible to actively identify and e…
Skills: Client Acquisition, Account Management, Territory Planning, CRM Software, Market Analysis
Glendale, California, United States · On-site
$22/hr–$23/hr
Job DetailsJob Location: Glendale, CA 91204Position Type: Full TimeSalary Range: $22.00 - $23.00 HourlyTravel Percentage: 75%Entry-Level Opportunity | Paid Travel Time + Mileage Reimbursement Based in Glendale | Travel T…
Skills: Customer Service, Microsoft Word, Microsoft Excel, Time Management, Communication Skills
Rockford Township, Illinois, United States · Remote Solely
$45/hr–$52/hr
Job DetailsJob Location: Rockford, IL 61108Position Type: Full TimeSalary Range: $45.00 - $52.00 HourlyTravel Percentage: NoneAre you passionate about clinical quality, accuracy, and continuous improvement -and looking f…
Skills: Utilization Review, Quality Assurance, Clinical Documentation Review, Medical Record Review, ERISA Compliance
Mount Laurel, New Jersey, United States · Remote OK
$22/hr–$30/hr
Job DetailsJob Location: Mount Laurel, NJ 08054Position Type: Full TimeSalary Range: $22.00 - $30.00 HourlyTravel Percentage: 10%Exam Works is looking for a Medical Coding Specialist to join our team remotely! *Must poss…
Skills: Medical Coding, Medical Billing, CPT Guidelines, ICD 10, HIPAA Compliance
Atlanta, Georgia, United States · On-site
$80k–$90k/yr
Job DetailsJob Location: Atlanta, GA 30305Position Type: Full TimeSalary Range: $80,000.00 - $90,000.00 Base+Commission/yearTravel Percentage: 50%The Director of Business Development (DBD) is responsible for identifying …
Skills: Business Development, Sales Strategy, Client Relationship Management, Market Analysis, Presentation Skills
Redding, California, United States · On-site
$23/hr–$24/hr
Job DetailsJob Location: Redding, CA 96002Position Type: Full TimeSalary Range: $23.00 - $24.00 HourlyTravel Percentage: 10%Entry-Level Opportunity | Paid Travel Time + Mileage Reimbursement Based in Redding, CA | Travel…
Skills: Customer Service, Microsoft Word, Microsoft Excel, Time Management, Written Communication
Roseland, New Jersey, United States · On-site
$28/hr–$33/hr
Job DetailsJob Location: Roseland, NJ 07068Position Type: Full TimeSalary Range: $28.85 - $33.65 HourlyExamWorks is looking for a Billing and Collections Supervisor to join our team! The Billing and Collections Superviso…
Skills: Billing, Collections, Accounts Receivable, Staff Supervision, Financial Reporting
Mount Laurel, New Jersey, United States · Remote OK
$90k–$100k/yr
Job DetailsJob Location: Mount Laurel, NJ 08054Position Type: Full TimeSalary Range: $90,000.00 - $100,000.00 Base+Commission/yearTravel Percentage: 25%Prizm LLC (an ExamWorks company) is seeking an experienced sales pro…
Skills: Business Development, Account Management, Sales Strategy, Medical Legal Industry Knowledge, Client Relationship Management
Portland, Oregon, United States · Remote Solely
$20/hr–$22/hr
Job DetailsJob Location: Portland, OR 97204Position Type: Full TimeSalary Range: $20.00 - $22.00 HourlyTravel Percentage: NoneAllMed is looking for a dedicated Pharmacy Technician to join our growing team! This is your c…
Skills: Quality Assurance, Medical Terminology, Anatomy and Physiology, Pharmacology, Clinical Citations
Atlanta, Georgia, United States · On-site
$200k–$220k/yr
Job DetailsJob Location: Atlanta, GA 30305Position Type: Full TimeSalary Range: $200,000.00 - $220,000.00 Salary/yearTravel Percentage: 10%If you have experience in sell-side equity research, investment banking, or buy-s…
Skills: Investor Relations Strategy, Financial Modeling, Valuation, Equity Research, Investment Banking
Oldsmar, Florida, United States · Remote OK
$22/hr–$26/hr
Job DetailsJob Location: Oldsmar, FL 34677Position Type: Full TimeSalary Range: $22.00 - $26.00 HourlyTravel Percentage: NoneApplicants must have paralegal experience in the state of Florida to be considered. If you're a…
Skills: Paralegal Experience, Data Entry, Customer Service, HIPAA Compliance, Microsoft Word
Atlanta, Georgia, United States · Remote OK
Job DetailsJob Location: Atlanta, GA 30305Position Type: Full TimeExamWorks is seeking a strategic, technologically skilled, and collaborative individual with experience in leading implementations and operational change …
Skills: Change Management, Salesforce Adoption, Stakeholder Management, Organizational Development, Strategic Planning
Redding, California, United States • On-site
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The role involves reviewing and refining medical reports, chronologies, and provider bills to ensure clinical accuracy and compliance with federal and state mandates. The auditor collaborates with physicians to resolve inconsistencies and ensures all determinations are supported by current medical citations.
Candidates must be a Registered Nurse (RN) with an active license and specific experience in the Intensive Care Unit (ICU). A bachelor's or associate degree in nursing or five years of related experience is required.
Job DetailsJob Location: Redding, CA 96002Position Type: Full TimeSalary Range: $34.00 - $35.00 HourlyTravel Percentage: None All candidates must reside in the Pacific Time Zone. You must also be a Registered Nurse (RN) with an active license and have ICU experience.
Why Join Us?
Are you a meticulous RN who loves diving into clinical data? Do you want to use your medical expertise outside of direct patient care to impact healthcare integrity?
As our Clinical Quality Assurance Nurse Auditor, you will be the final line of defense for medical accuracy and compliance. Your expertise ensures that clinical reports, medical record chronologies, and billing reviews are bulletproof, evidence-based, and of the highest professional standard. This is a high-impact role where your sharp clinical eye directly protects patients, providers, and healthcare standards.
What You Will Do (Your Impact)
Champion Report Excellence: Review and refine critical medical reports, chronologies, and provider bills to ensure flawless clinical accuracy and professional presentation.
Uphold Evidence-Based Medicine: Verify that every clinical determination is backed by robust, current citations from reputable medical journals.
Act as a Strategic Partner: Collaborate directly with reviewing physicians to clarify complex case details and resolve inconsistencies.
Guard Compliance & Integrity: Ensure full alignment with federal ERISA regulations, state mandates, and client specifications, while strictly verifying that no conflicts of interest exist.
Solve Problems Proactively: Help resolve client quality questions, recover missing medical data, and provide management with strategic insights on consultant performance.
Clinical Expertise: Active Registered Nurse (RN) license with strong clinical judgment.
A Sharp Eye for Detail: Exceptional proofreading, auditing, and analytical skills.
The Ability to Connect Dots: Deep understanding of medical coding, hospital billing, and record chronologies.
Regulatory Knowledge: Familiarity with state and federal healthcare mandates (like ERISA) is a massive plus.
Communication Skills: Ability to give constructive feedback to medical peers and providers with professionalism and clarity.
Organ donations
Intensive Care Unit (ICU)
Education and/or Experience
Bachelor/Associate degree in nursing or related field; or minimum five years related experience; or equivalent combination of education and experience. Experience with medical terminology, medications, medical specialties and treatment protocols required. Experience in the insurance industry preferred.
RN/LPN license
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 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 verify 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 and/or state mandates and is documented accurately on the case report.
Verify that the 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 Reviewer to obtain clarification, modification or correction as needed.
Contact the appropriate person to recover any missing documentation or verify charges.
Assist in resolution of customer complaints and quality assurance issues as needed.
Ensure all federal ERISA 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 continuing education requirements and or training activities.
Perform other duties as assigned.
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.
Equal Opportunity Employer - Minorities/Females/Disabled/Veterans
A leading provider of independent medical exams, peer reviews, bill reviews, Medicare compliance and related services.
The ExamWorks Group platform, family company services, applications and portals for the management of independent medical claim review are the assets of choice among claims professionals. Our global service network and private cloud-based computing platform connects medical professionals, case managers, and claimants to property, casualty, and disability insurers, third-party administrators, and legal professionals so they can provide evidence-based independent expert medical opinions and analysis for claims resolution. Secure, streamlined, automated, customized, independently audited and accredited workflows assist clients to manage costs by verifying the validity, nature, cause, and extent of claims, identifying fraud and providing fast, efficient and quality IME services.
Offices: 3280 Peachtree Road NE, Suite 2625, Atlanta, GA 30305, US
A leading provider of independent medical exams, peer reviews, bill reviews, Medicare compliance and related services.
The ExamWorks Group platform, family company services, applications and portals for the management of independent medical claim review are the assets of choice among claims professionals. Our global service network and private cloud-based computing platform connects medical professionals, case managers, and claimants to property, casualty, and disability insurers, third-party administrators, and legal professionals so they can provide evidence-based independent expert medical opinions and analysis for claims resolution. Secure, streamlined, automated, customized, independently audited and accredited workflows assist clients to manage costs by verifying the validity, nature, cause, and extent of claims, identifying fraud and providing fast, efficient and quality IME services.
Offices: 3280 Peachtree Road NE, Suite 2625, Atlanta, GA 30305, US
