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Disability Claims QA Specialist

1 day, 5 hours ago
United States
Full-time
Senior
Manual QA Tester
Quality Assurance and Testing
Apply Now
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
201-500
Founded 2008
View All Jobs 5

Description

  • Assess physician reports against client and jurisdictional standards for long-term disability claims.
  • Verify that claim documentation supports physicians’ determinations.
  • Apply policy guidelines and healthcare terminology to evaluate whether long-term disability criteria are met.
  • Communicate with physician reviewers and their teams to clarify information and ensure all questions are addressed.
  • Work directly with clients on individual cases to deliver complete, timely, error-free QA outcomes.
  • Manage oversight of complex LTD cases requiring additional review before client delivery.
  • Provide an additional level of QA for cases with identified quality issues.
  • Complete assigned special projects and other duties based on business needs.

Requirements

  • Disability claims experience is required.
  • 5+ years of claims experience is preferred.
  • Associate’s or Bachelor’s degree is preferred.
  • Experience in a healthcare and/or insurance business setting is preferred.
  • Ability to interpret policy guidelines and healthcare terminology for disability claims.
  • Excellent written and verbal communication skills.
  • Strong attention to detail, critical-thinking ability, and time-management skills.
  • Ability to work with urgency and meet client deadlines.
  • Self-motivation and a strong drive for performance excellence.
  • Computer literacy and typing skills; experience with Google Chrome, Gmail, Docs, and Sheets is a plus.
  • Ability to work from home with self-provided, uninterrupted internet service.
  • Ability to work for extended periods at a computer while sitting.

Benefits

  • Compensation based on experience, education, and skills, plus performance bonuses.
  • Medical, dental, and vision coverage for employees and families.
  • 401(k) plan with company match.
  • Generous paid time off.
  • Employer-paid basic life insurance, short-term disability, and long-term disability coverage.
  • Voluntary life, hospital indemnity, critical illness, accident indemnity, and pet insurance plans.
  • Apple equipment and a media stipend for the remote workspace.

Interested in this position?

Apply directly on the company website

Apply Now

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