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Group Health QA Specialist

4 hours, 57 minutes ago
United States
Full-time
Mid Level
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
251-1K
Founded 2008
View All Jobs 13

Description

  • Communicate with clients, reviewers, and management to keep reports moving toward on-time completion.
  • Provide regular report status updates to clients and manage clarification and addendum requests.
  • Review physician reports for quality, including clinical rationale, accuracy, spelling, grammar, punctuation, format, and completeness.
  • Confirm that reports meet client-specific requirements and all applicable state or jurisdictional standards.
  • Work directly with physicians and office staff to resolve questions, request clarifications, and obtain approval and signatures for final reports.
  • Follow up with clients and physicians to obtain missing information needed for referrals and report completion.
  • Distribute final reports to clients according to their requirements.
  • Participate in client calls or meetings when a report is in question.
  • Provide oversight to team members and act as a liaison with the VP of Clinical Operations on quality issues and new reviewer reports.
  • Continuously improve processes to improve turnaround time, peer-to-peer success rates, and reduce client returns for clarification.

Requirements

  • An Associate’s Degree or Bachelor’s Degree is preferred.
  • Business experience in a healthcare and/or insurance setting is preferred.
  • Exceptional communication skills with a clear 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 perform the physical demands of the role, including sitting for long periods and doing computer work.
  • Ability to travel or perform tasks involving lifting, bending, or other physical activity as required.
  • Must supply and support their own internet service for work from home.
  • Must maintain an uninterrupted internet connection for the work-from-home role.

Benefits

  • Medical, dental, and vision coverage for employees and their families.
  • Voluntary life insurance options for employees, spouses, and children.
  • Additional voluntary benefits including hospital indemnity, critical illness, accident indemnity, and pet insurance.
  • Basic life insurance, short-term disability, and long-term disability coverage at no cost.
  • Generous paid time off.
  • 401(k) plan with company match.
  • 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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