Clinical Quality Reviewer - Remote

Overview

The Clinical Quality Reviewer plays a pivotal role in ensuring the clinical accuracy, compliance, and claim-readiness of documentation generated by Telemedica’s provider network. This role combines healthcare quality standards with specialized knowledge of VA disability claims to ensure veterans receive medical evidence that supports the integrity and efficacy of their claims.

In Short

• Review completed DBQs, Nexus Letters, IMOs and other medical evidence documentation.
• Validate medical logic and adherence to documentation standards.
• Return documents for provider revision when necessary.
• Manage the clinical help desk system for provider corrections.
• Track turnaround times and report quality trends.
• Provide clinical-specific education to providers.
• Build out standardized checklists and QA workflows.
• Serve as a clinical knowledge resource for teams.
• Help develop provider training based on QA trends.
• Stay current with VA disability claim requirements.

Requirements

• A valid and active license as a Registered Nurse (RN) or relevant clinical license.
• 3+ years in clinical documentation or quality assurance role.
• Strong written communication and editing skills.
• Deep understanding of the VA disability claims process.
• Experience with CRM, EHR, or care management platforms.

Benefits

• Healthcare: PPO and HSA plans.
• Retirement: 401(k) with up to 3% employer match.
• Paid Time Off: 30 Days PTO, plus 12 paid holidays.
• Insurance: Short and Long-Term Disability, Life Insurance.
• Other Benefits: Employee discounts, Jury Duty Pay, Time-Off to Vote.