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Job ID 2118848
Job Description
OVERVIEW
As a pivotal part of the medical file review process, the Quality Analyst plays a crucial role in ensuring the highest standards of client service and report accuracy. This position involves meticulously examining completed referrals to confirm that all client inquiries are addressed and that the associated reports are correct. Upholding both client and departmental standards is a key responsibility in this dynamic role.
At Dane Street, our success stems from the collective efforts of our team members. We prioritize caring for our customers and each other while fostering a workplace culture that encourages positivity and promotes outstanding client satisfaction and results.
KEY RESPONSIBILITIES
Quality Audit Duties
- Conduct thorough reviews of reports and accompanying medical records to ensure completeness and that all client questions have been satisfactorily answered.
- Engage with reviewers for any further inquiries or necessary clarifications.
- Communicate with clients to clear up additional questions they may have.
- Provide regular updates to clients on referral status.
- Verify that reports are polished, free of grammatical and spelling errors.
- Ensure compliance with the QA checklist for each referral prior to finalization.
- Format reports professionally for final approval.
Effective Communication
- Maintain clear and concise communication between clients, reviewers, and the Operations team.
- Confidently engage with physicians and clients to discuss the specifics of their peer reviews.
Perform other tasks and special projects as assigned based on the evolving needs of the business.
QUALIFICATIONS
EDUCATION/CREDENTIALS:
A preference for candidates with an Associate’s Degree or Bachelor’s Degree.
RELEVANT EXPERIENCE:
Experience in a healthcare or insurance business setting is desirable. Familiarity with technology-driven processes in a professional environment is also preferred.
SKILLS & COMPETENCIES:
Strong communication skills are essential, along with a solid understanding of company services. Candidates should exhibit critical thinking abilities, effective time management, and the capacity to meet tight deadlines. Proficiency in technology and typing skills is necessary.
WORK ENVIRONMENT:
Physical demands include the potential for lifting, bending, or traveling as required to fulfill job responsibilities. Expect long periods of sitting and computer usage.
REMOTE WORK REQUIREMENTS:
Employees must supply and maintain their own internet service, ensuring a reliable connection for work-from-home responsibilities.
Please note that this job description may evolve over time to reflect changing business needs.
COMPENSATION & BENEFITS
Become a part of the Dane Street family and take advantage of a robust benefits package tailored to enhance your well-being and ease your mind. We provide comprehensive medical, dental, and vision coverage for you and your family, alongside optional life insurance for you, your spouse, and children. Additional voluntary benefits include hospital indemnity, critical illness coverage, accident indemnity, and pet insurance plans. We offer basic life insurance and short- and long-term disability coverage at no cost to employees. A generous paid time off policy empowers you to take the time you need to relax and rejuvenate, while our 401k plan with company match positions you for a secure future. Remote workers are supplied with Apple equipment and receive a media stipend for their home office.
ABOUT DANE STREET:
Dane Street is a rapidly growing Inc. 500 Company fueled by a high-performance culture, seeking innovative professionals to join our team. We process over 200,000 insurance claims each year for major national and regional Workers’ Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. Our customized Independent Medical Exams and Peer Review programs are instrumental in helping our clients make informed medical determinations as part of their claims management processes.