IME Quality Analyst - Washington Workers' Compensation

Summary

Dane Street is a fast-paced, Inc. 500 Company specializing in medical file review for Workers’ Compensation and other insurance claims. The Quality Analyst will manage the review process, ensuring accuracy and client satisfaction through effective communication and quality audits.

Responsibilities

• Reviews reports accompanying medical records to ensure that the report is complete and that all questions posed by the client have been addressed
• Follows up with the reviewer with any additional questions or clarifications needs
• Follows up with the client should there be any additional questions
• Updates clients frequently on referral progress
• Ensures the report is grammatically correct with no spelling errors
• Ensures each referral adheres to the QA checklist prior to the completion
• Formats reports for approval
• Communicates clearly and concisely between the customer, reviewer, and Operations team
• Must confidently speak with physicians and clients regarding the content of their peer reviews
• Other duties & special projects, as assigned and based on business needs

Skills

• The Quality Analyst is responsible for managing the various aspects of the medical file review process
• They will review the completed referral to ensure client questions have been addressed appropriately and review the completed report for accuracy
• Ensuring client and department standards have been met
• Reviews reports accompanying medical records to ensure that the report is complete and that all questions posed by the client have been addressed
• Follows up with the reviewer with any additional questions or clarifications needs
• Follows up with the client should there be any additional questions
• Updates clients frequently on referral progress
• Ensures the report is grammatically correct with no spelling errors
• Ensures each referral adheres to the QA checklist prior to the completion
• Formats reports for approval
• Communicates clearly and concisely between the customer, reviewer, and Operations team
• Must confidently speak with physicians and clients regarding the content of their peer reviews
• 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
• Supply and support their own internet services
• Maintaining an uninterrupted internet connection is a requirement of all work from home position
• 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

Qualifications

Must Haves

• The Quality Analyst is responsible for managing the various aspects of the medical file review process
• They will review the completed referral to ensure client questions have been addressed appropriately and review the completed report for accuracy
• Ensuring client and department standards have been met
• Reviews reports accompanying medical records to ensure that the report is complete and that all questions posed by the client have been addressed
• Follows up with the reviewer with any additional questions or clarifications needs
• Follows up with the client should there be any additional questions
• Updates clients frequently on referral progress
• Ensures the report is grammatically correct with no spelling errors
• Ensures each referral adheres to the QA checklist prior to the completion
• Formats reports for approval
• Communicates clearly and concisely between the customer, reviewer, and Operations team
• Must confidently speak with physicians and clients regarding the content of their peer reviews
• 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
• Supply and support their own internet services
• Maintaining an uninterrupted internet connection is a requirement of all work from home position

Nice to Haves

• 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

Benefits

• Comprehensive benefits package designed to support your well-being and peace of mind
• Medical, dental, and vision coverage for you and your family
• Voluntary life insurance options for you, your spouse, and your children
• Voluntary benefits: hospital indemnity, critical illness, accident indemnity, and pet insurance plans
• Basic life insurance coverage at no cost
• Short-term disability coverage at no cost
• Long-term disability coverage at no cost
• Generous paid time off policy
• 401k plan with a company match
• Apple equipment provided for remote workspace
• Media stipend provided for remote workspace