Nsure Healthcare · 6 days ago
Clinical QA Specialist
Nsure Healthcare is focused on ensuring patient safety and regulatory compliance in clinical workflows. The Clinical QA Specialist is responsible for auditing clinical calls and documentation, identifying risks, and partnering with leadership to drive quality improvement initiatives.
BillingHealth CareMedicalSoftware
Responsibilities
Conduct weekly audits of clinical calls and charts (minimum: 1 call + 15 charts per eligible rep; 3 calls and 45 charts per month)
Evaluate adherence to clinical action steps, patient education requirements, identity verification, and disclosure standards
Identify infractions and document findings for coaching, corrective action, and disciplinary processes as required
Ensure accurate information and proper call handling to protect patient safety
Validate prompt escalation of urgent clinical concerns
Enforce compliance with healthcare regulations and patient privacy requirements
Verify required disclosures and documentation standards
Partner with supervisors to review infractions and support coaching/corrective action
Provide actionable feedback to improve clinical quality, accuracy, and efficiency
Identify trends and contribute to targeted training plans
Leverage Authenticx (AI-powered call analysis) to measure script adherence, compliance, soft skills, and clinical KPIs
Support trend reporting and continuous quality improvement initiatives
Qualification
Required
Active RN or LPN/LVN license (multi-state preferred)
2+ years of clinical experience (telehealth, RPM/CCM, or ambulatory preferred)
Experience auditing clinical documentation and/or call interactions
Strong knowledge of clinical workflows, escalation protocols, and patient education
High attention to detail with excellent written documentation skills
Comfort working in QA systems and AI-assisted analytics tools
Preferred
Prior QA, utilization review, or quality improvement experience
RPM/CCM program familiarity
Experience with call center clinical operations
Familiarity with Authenticx or similar QA platforms
Company
Nsure Healthcare
Nsure helps hundreds of healthcare providers accelerate cash flow and increase efficiency throughout the country.
Funding
Current Stage
Early StageRecent News
Fintech Schweiz Digital Finance News - FintechNewsCH
2025-11-29
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