Claims Quality Analyst, NY

Dane Street, LLC

22h • Remote

About The Position

The Quality Analyst is responsible for managing the various aspects of the medical file review process. They will review the completed referral to ensure client questions have been addressed appropriately and review the completed report for accuracy. Ensuring client and department standards have been met.
Dane Street’s success relies on individual and team contributions every day. We care for our customers, each other and Dane Street. It is the responsibility for all of us to maintain a positive working environment that promotes client satisfaction and results.

Requirements

• Present exceptional communication skills with a clear understanding of company business lines. The ability to apply critical thinking, manage time efficiently and meet specific deadlines. Computer literacy and typing skills are essential.
• Ability to handle high volume and meet deadlines.
• Supply and support their own internet services.
• Maintaining an uninterrupted internet connection is a requirement of all work from home position.

Nice To Haves

• An Associate’s Degree or Bachelor’s Degree is preferred.
• Business experience in a healthcare and/or insurance setting is preferred.
• NY Workers Compensation experience is preferred.
• Operations experience with Peer Review, UR and/or case management. Working with technology based processes within the business environment.

Responsibilities

• Reviews reports accompanying medical records to ensure that the report is complete and that all questions posed by the client have been addressed.
• Follows up with the reviewer with any additional questions or clarifications needs.
• Follows up with the client should there be any additional questions.
• Updates clients frequently on referral progress.
• Ensures the report is grammatically correct with no spelling errors.
• Ensures each referral adheres to the QA checklist prior to the completion.
• Formats reports for approval.
• Communicates clearly and concisely between the customer, reviewer, and Operations team
• Must confidently speak with physicians and clients regarding the content of their peer reviews.
• Other duties & special projects, as assigned and based on business needs.

Benefits

• We offer a range of benefits including medical, dental, and vision coverage for you and your family.
• Additionally, we offer voluntary life insurance options for you, your spouse, and your children.
• We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans.
• Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost.
• Our generous paid time off policy ensures you have time to relax and recharge, while our 401k plan with a company match helps you plan for your future.
• Apple equipment and a media stipend are provided for remote workspace.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree
• Number of Employees: 101-250 employees