Peer/Record Review Quality Analyst

🕒 il y a 4 jours

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Dane Street

Site WebLinkedInTous les Emplois

51 - 200 employés

⚕️ Assurance santé

📋 Conformité

🏛️ Gouvernement

Healthcare Insurance • Compliance • Government

Dane Street est un leader national dans les examens et évaluations médicales indépendants, fournissant des examens médicaux indépendants, des revues par les pairs et d'autres rapports médicaux objectifs, conformes et en temps opportun. Avec un vaste réseau de plus de 16 000 médecins, l'entreprise offre ses services dans plus de 25 000 emplacements et 100 spécialités, y compris les réclamations en matière de compensation des travailleurs, d'automobile, de responsabilité et d'invalidité. Dane Street soutient les assureurs, les administrateurs tiers, les organisations de soins intégrés et les entités fédérales/étatiques avec des analyses médicales expertes, les aidant à prendre des décisions précises. L'entreprise est reconnue pour sa qualité, ses délais d'exécution rapides et ses processus efficaces, recevant des distinctions telles que l'accréditation NCQA en gestion de l'utilisation et la certification Great Place to Work.

Description

• Managing the various aspects of the medical file review process • Reviewing the completed referral to ensure client questions have been addressed appropriately • Reviewing the completed report for accuracy • Ensuring client and department standards have been met • Conducting quality audits • Following up with the reviewer with any additional questions or clarifications needed • Following up with the client should there be any additional questions • Updating clients frequently on referral progress • Ensuring the report is grammatically correct with no spelling errors • Ensuring each referral adheres to the QA checklist prior to completion • Formatting reports for approval • Communicating clearly and concisely between the customer, reviewer, and Operations team • Confidently speaking with physicians and clients regarding the content of their peer reviews.

🎯 Exigences

• An Associate’s Degree or Bachelor’s Degree is preferred • Business experience in a healthcare and/or insurance setting is preferred • Working with technology based processes within the business environment • 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

🏖️ Avantages

• medical, dental, and vision coverage for you and your family • voluntary life insurance options for you, your spouse, and your children • other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans • basic life insurance • short-term disability • 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