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Dane Street

National physician-based IME and peer reviews

Disability Clinical RN Quality Assurance Specialist

Claims AdjudicationConfirmed live in the last 24 hours
Full-timeRemote in USA

About the Job

Requirements

  • An RN credential is required.
  • Disability experience is required.
  • Excellent written and verbal communication skills are required.
  • Proficiency navigating computer programs is required; Google Chrome, Gmail, Docs, and Sheets experience is a plus.
  • Attention to detail is required.
  • The ability to meet deadlines and work with a sense of urgency is required.
  • The ability to apply critical thinking and manage time efficiently is required.
  • Computer literacy and typing skills are essential.
  • Applicants must supply and support their own internet service and maintain an uninterrupted internet connection.
  • Long periods of sitting and computer work are required.

Responsibilities

  • Assess physician reports for compliance with client and jurisdictional standards specific to long-term disability claims.
  • Verify that claims support physicians’ determinations in long-term disability claims.
  • Read and apply policy guidelines and healthcare terminology, and determine when long-term disability criteria are met.
  • Work with clients case by case to deliver complete, timely, and accurate quality assurance for long-term disability cases.
  • Manage and provide oversight for complex long-term disability cases that require additional review before being returned to the client.
  • Provide an additional level of quality assurance for cases with quality issues, using clinical claims knowledge specific to long-term disability.
  • Participate in other duties and special projects as assigned based on business needs.

Desired Qualifications

  • An associate’s degree or bachelor’s degree is preferred.
  • Five or more years of claims experience is preferred.
  • Business experience in a healthcare or insurance setting is preferred.
  • Experience with Google Chrome, Gmail, Docs, and Sheets is a plus.

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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