Group Health Customer Service Representative

🕒 June 30

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Dane Street

WebsiteLinkedInAll Job Openings

51 - 200 employees

⚕️ Healthcare Insurance

📋 Compliance

🏛️ Government

Healthcare Insurance • Compliance • Government

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

• Handling Receipt of New Cases: • Intake new cases and review/verify information and requests. Draft cases by entering information into the Dane Street system, AccessDS. • Work with client on any information missing pertinent to processing claim. • Sort, organize and create medical document listing - if required by client, and in line with specific special handling. • Oversight of Cases: • Monitor, process and track cases to ensure we meet deadlines. • Assignment of Cases: • Assign/schedule new cases to physicians for review with the appropriate physician, based on location, reviewer availability, specific guidelines, jurisdictional requirements and other client requirements. • Ensure that the assigned physician has no conflict of interest with the case assignments. • Client Interaction: • Update clients frequently on cases in progress. • May communicate when there are questions on referral information to ensure proper documentation and information is provided to the assigned reviewer. • Ensure proper documentation for specified cases is provided to the client.

🎯 Requirements

• A minimum of 1 year of experience working in an administrative or clerical role in a business office environment is required. • Experience working in a healthcare (medical office, insurance claims, etc.) environment preferred. • Excellent computer skills (Apple Operating System, Google Chrome search engine, Gmail are preferred). • Stellar written and verbal communication skills, including a high comfort level in speaking with the referring client, claimants, and/or physician. • Ability to maintain focus and attention to detail in a fast-paced environment. • Ability to manage multiple tasks and quickly changing priorities. • Excellent organizational skills.

🏖️ Benefits

• 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, and long-term disability coverage at no cost. • generous paid time off policy ensures you have time to relax and recharge. • 401k plan with a company match helps you plan for your future. • Apple equipment and a media stipend are provided for remote workspace.