Claims Quality Analyst, NY

3 weeks, 1 day ago
Full-time
Junior
Quality Assurance and Testing
Dane Street

Dane Street

Dane Street provides independent medical examination and peer review services tailored for the insurance industry, focusing on areas such as workers' compensation, disability, and auto liability, while emphasizing quality, compliance, and timely delive...

Insurance
251-1K
Founded 2008

Description

  • Review completed referrals and accompanying medical records to ensure all client questions are addressed.
  • Audit completed reports for accuracy, completeness, grammar, and spelling.
  • Follow up with reviewers to request additional information or clarifications as needed.
  • Communicate with clients regarding additional questions and referral progress.
  • Ensure each referral follows the QA checklist before completion.
  • Format reports for approval.
  • Communicate clearly and concisely with customers, reviewers, and the Operations team.
  • Speak confidently with physicians and clients about peer review content.
  • Manage high-volume work while meeting deadlines.
  • Perform other duties and special projects as assigned based on business needs.

Requirements

  • Associate’s degree or Bachelor’s degree preferred.
  • Business experience in a healthcare and/or insurance setting preferred.
  • NY Workers’ Compensation experience preferred.
  • Operations experience with Peer Review, UR, and/or case management preferred.
  • Experience working with technology-based processes in a business environment.
  • Strong communication skills with an understanding of company business lines.
  • 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 work under deadline pressure.
  • Ability to supply and support your own internet service with an uninterrupted connection for remote work.

Benefits

  • Medical, dental, and vision coverage for employees and their families.
  • Voluntary life insurance for employees, spouses, and children.
  • Additional voluntary benefits including hospital indemnity, critical illness, accident indemnity, and pet insurance.
  • Company-paid basic life insurance, short-term disability, and long-term disability coverage.
  • Generous paid time off policy.
  • 401(k) plan with company match.
  • Apple equipment and a media stipend provided for the remote workspace.

Interested in this position?

Apply directly on the company website

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