QA Supervisor

🕒 Maio 27

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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

• Oversight of QA staff • Ensure appropriate QA staff are assigned to each file to designate file handling responsibilities amongst the team • Supervise the assigned staff and manage the File Review Board to ensure a timely and accurate process of each file • Provide details of board reviews to managers to ensure efficiency and productivity of staff • Assist in identifying & correcting staff performance including promotions, discipline, coaching and termination of staff • Assist in hiring qualified candidates for QA open positions • Ensure that all QA staff adhere to and meet their specific job duties • Following up with Physicians for outstanding reports • Reviewing received reports for accuracy • Delivering completed reports back to all applicable parties • Following all client-specific instructions • Actively participate in issue resolution by working with the required QA, physicians, account managers, and/or other related parties • Follow up with physicians with any additional questions or need for further clarification • Ensure referrals meet the client-directed Turn Around Time (TAT) • Ensure correct Doctor Payment amount and Client Invoice amount upon approval of referrals • Review reports accompanying medical records to ensure that the report is complete, that all questions posed have been addressed and that the report is free of errors • Assist management team with intake completion • Act as the liaison between the reviewer, team member and client regarding the process or status of the file • Assist in communications with the requester regarding questions and issues • Other duties & special projects, as assigned and based on business needs

🎯 Requisitos

• An Associate’s Degree or Bachelor’s Degree is preferred • Medical peer review or healthcare industry knowledge required • 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

🏖️ Benefícios

• medical, dental, and vision coverage for you and your family • voluntary life insurance options for you, your spouse, and your children • hospital indemnity, critical illness, accident indemnity, and pet insurance plans • basic life insurance, short-term disability, and long-term disability coverage at no cost • generous paid time off policy • 401k plan with a company match • Apple equipment and a media stipend for remote workspace