Disability Claims QA Specialist

🔥 4 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔧 QA Engineer (Quality Assurance)

👻 Ghost score 25%

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Dane Street

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

💼 Consulting

⚖️ Legal

Healthcare • Consulting • Legal

Dane Street is a national leader in Independent Medical Exams and Reviews, providing objective, compliant, and timely Independent Medical Examinations, Peer Reviews, and other medical reports. With a large network of over 16,000 physicians, the company offers its services across 25,000 locations and 100 specialties, including Workers' Compensation, Auto, Liability, and Disability claims. Dane Street supports Insurance Carriers, Third Party Administrators, Managed Care Organizations, and Federal/State entities with expert medical analyses, helping them make accurate determinations. The company is recognized for its quality, fast turnaround times, and efficient processes, earning accolades like the NCQA Accreditation in Utilization Management and the Great Place to Work certification.

📋 Description

• Assess the quality of physician reports against client and jurisdictional standards for long-term disability claims • Verify that claims support physicians’ determinations in long-term disability claims • Read and apply policy guidelines and healthcare terminology to determine when long-term disability criteria are met • Work with clients case by case to deliver complete, timely, and error-free quality assurance • Communicate with physician reviewers and their teams to clarify information, address questions, and meet client deadlines • Manage and oversee complex long-term disability cases requiring additional review • Provide an additional level of quality assurance for cases with quality issues using clinical claims knowledge • Participate in other duties and special projects as assigned • Review reports accompanying medical records for accuracy and completeness

🎯 Requirements

• Disability experience required • 5+ years of claims experience preferred • Associate’s Degree or Bachelor’s Degree preferred • Business experience in a healthcare and/or insurance setting preferred • Must work with a sense of urgency and meet deadlines • Must be self-motivated, with a strong drive for performance excellence • Excellent written and verbal communication skills required • Proficiency navigating computer programs; experience with Google Chrome, Gmail, Docs, and Sheets is a plus • Attention to detail required • Exceptional communication skills and clear understanding of company business lines • Ability to apply critical thinking, manage time efficiently, and meet specific deadlines • Computer literacy and typing skills essential • Must supply and support own internet services • Uninterrupted internet connection required for work-from-home position

🏖️ Benefits

• Medical, dental, and vision coverage for employees and families • Voluntary life insurance for employees, spouses, and children • Hospital indemnity, critical illness, accident indemnity, and pet insurance plans • Basic life insurance at no cost • Short-term disability coverage at no cost • Long-term disability coverage at no cost • Generous paid time off • 401(k) plan with company match • Apple equipment for remote workspace • Media stipend for remote workspace • Performance bonuses • Remote work arrangement

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