Physician Advisory Services QA Specialist

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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

• Provide regular report status updates to clients • Evaluate physician reports for quality, client requirements, jurisdictional standards, and clinical rationale • Clarify ambiguous report questions with clients • Distribute final reports according to client-specific requirements • Coordinate clarification and addendum requests • Participate in client calls or meetings when reports are in question • Follow up with clients for missing referral information • Work directly with physicians to ensure client questions are answered with clinical rationale • Follow up with physicians or office staff to ensure on-time report delivery • Provide verbal or written feedback and clarification requests to physicians • Obtain physician approval and signature for final reports • Review reports for data accuracy, spelling, grammar, and punctuation • Ensure state reporting requirements and client-specific formatting requirements are met • Ensure special handling instructions for report completion and delivery are followed • Provide oversight to team members when needed • Improve processes to support turnaround time, peer-to-peer success rates, and client satisfaction • Provide final approval for case release to clients • Liaise with the VP of Clinical Operations on quality issue reports and new reviewer reports • Perform other duties and special projects as assigned

🎯 Requirements

• Associate’s Degree or Bachelor’s Degree preferred • Business experience in a healthcare and/or insurance setting preferred • Exceptional communication skills • Clear understanding of company business lines • Ability to apply critical thinking • Ability to manage time efficiently and meet specific deadlines • Computer literacy and typing skills • Ability to supply and support personal internet services • Uninterrupted internet connection required for work from home • Ability to perform required lifting, bending, traveling, prolonged sitting, and computer work

🏖️ Benefits

• Medical, dental, and vision coverage for employees and their families • Voluntary life insurance for employees, spouses, and children • Voluntary 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 • 401k plan with company match • Apple equipment for remote workspace • Media stipend for remote workspace