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Dane Street

National physician-based IME and peer reviews

Physician Advisory Services QA Specialist

Claims AdjudicationConfirmed live in the last 24 hours
Full-timeRemote in USANo salary listed

About the Job

Requirements

  • Business experience in a healthcare and/or insurance setting is preferred.
  • Computer literacy and typing skills are essential.
  • Ability to apply critical thinking, manage time efficiently, and meet specific deadlines.
  • Must supply and support their own internet service and maintain an uninterrupted internet connection for remote work.
  • Long periods of sitting and computer work are required; duties may involve lifting, bending, and traveling.

Responsibilities

  • Communicate with customers, reviewers, and management to ensure completed reports are delivered by customer-requested due dates.
  • Ensure timely completion and overall completeness of reviewer reports according to customer requirements, company best practices, and clinical accuracy.
  • Participate in improving company processes and work with the Manager to achieve high efficiencies.
  • Provide regular report status updates to clients.
  • Evaluate the quality of physician reports and determine whether they meet client and jurisdictional standards; ensure the clinical rationale supports physician determinations.
  • Clarify ambiguous report questions with clients.
  • Distribute final reports to clients according to client-specific requirements.
  • Coordinate and execute all aspects of client clarification and addendum requests.
  • Participate in client calls or meetings when a report is in question.
  • Follow up with clients for missing information pertinent to referrals.
  • Work directly with physicians to ensure client questions are answered and supported by clinical rationale.
  • Follow up with physicians or their office staff to ensure on-time report delivery.
  • Compose and provide verbal or written feedback to physicians regarding report quality.
  • Compose and provide verbal or written requests to physicians or their office staff for clarifications.
  • Receive physician confirmation that a report has the physician’s approval and ensure the physician signs the final report.
  • Review physician reports for data accuracy, including spelling, grammar, and punctuation.
  • Ensure all state reporting requirements are met.
  • Ensure reports are formatted according to each client’s specific requirements.
  • Ensure all client special handling instructions for report completion and delivery are met.
  • May provide oversight to team members’ work.
  • Continuously improve processes to facilitate better turnaround time and peer-to-peer success rates, reduce reports returned by clients for clarification, and improve client satisfaction.
  • Give final approval on cases for release to clients.
  • Act as a liaison and coordinate quality issue reports and new reviewer reports with the VP of Clinical Operations.
  • Perform other duties and special projects as assigned based on business needs.

Desired Qualifications

  • An Associate’s Degree or Bachelor’s Degree is preferred.
  • Business experience in a healthcare and/or insurance setting is preferred.

About the Company

Dane Street

National physician-based IME and peer reviews

Dane Street provides independent medical exams (IMEs) and peer-review services on a nationwide scale. It works with a panel of board-certified physicians located in all 50 states to deliver evaluations across Workers Compensation, Pharmacy, Disability, Group Health, and Auto/Liability cases. The process involves a physician-based review and evaluation system that produces expert reports with faster turnaround times, higher report quality, and increased satisfaction and productivity among adjusters and nurses. The company differentiates itself with its large, nationwide network and its focus on timely, high-quality evaluations across multiple lines of business. Its goal is to improve the accuracy and efficiency of medical reviews to support better decision-making for insurers, employers, and patients.

Company size
201-500
Company stage
Not listed
Total funding
Not listed
Headquarters
Palm Beach Gardens, FL
Founded
2008

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