PRN Physician Advisory Services QA Specialist

🕒 Maio 30

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Dane Street

SiteLinkedInTodas as Vagas

51 - 200 funcionários

⚕️ Seguro de Saúde

📋 Conformidade

🏛️ Governo

Healthcare Insurance • Compliance • Government

A Dane Street é líder nacional em Exames e Revisões Médicas Independentes, fornecendo Exames Médicos Independentes (IMEs), Revisões por Pares e outros laudos médicos de forma objetiva, em conformidade e dentro dos prazos. Com uma ampla rede de mais de 16. 000 médicos, a empresa oferece serviços em 25. 000 localidades e 100 especialidades, incluindo sinistros de compensação trabalhista (Workers’ Compensation), automóvel, responsabilidade civil (Liability) e incapacidade (Disability). A Dane Street atende seguradoras, Third-Party Administrators (TPAs), organizações de Managed Care e órgãos federais/estaduais com análises médicas especializadas, ajudando-os a tomar decisões precisas. A empresa é reconhecida pela qualidade, prazos de entrega ágeis e processos eficientes, tendo conquistado credenciais como a Acreditação da NCQA em Utilization Management e a certificação Great Place to Work.

Descrição

• The QA Specialist plays an integral role in the review process. • Responsible for communicating with the customer, reviewer, and management to ensure a completed report is delivered. • Responsible for the timely completion and overall completeness of a reviewer report. • Participate in improving DS processes and work with the Manager to ensure high efficiencies. • Provides regular report status updates to the client. • Evaluates the Quality of physician’s report and ensures compliance with standards. • Clarifies ambiguous report questions with clients and distributes final report. • Works directly with physicians to ensure client questions are answered. • Reviews each physician report for data accuracy including spelling, grammar & punctuation. • Responsible for the final approval on cases for release to the client.

🎯 Requisitos

• An Associate’s Degree or Bachelor’s Degree is preferred. • Business experience in a healthcare and/or insurance setting is preferred. • 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. • Any lifting, bending, traveling, etc. required to do the job duties listed above. • Long periods of sitting and computer work. • Supply and support their own internet services. • Maintaining an uninterrupted internet connection is a requirement of all work from home position.