Legal Quality Assurance Specialist

August 8

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Dane Street

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IMEs • Physician Advisor Reviews • Peer Reviews • Drug Utilization Reviews

51 - 200 employees

⚕️ Healthcare Insurance

📋 Compliance

🏛️ Government

Description

• JOB SUMMARY • The Legal QA Specialist 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. • Dane Street’s success relies on individual and team contributions every day. • We care for our customers, each other and Dane Street. • It is the responsibility for all of us to maintain a positive working environment that promotes client satisfaction and results. • MAJOR DUTIES & RESPONSIBILITIES • Quality Audits • 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. • Communication • 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.

Requirements

• EDUCATION/CREDENTIALS: • An Associate’s Degree or Bachelor’s Degree is preferred. • JOB RELEVANT EXPERIENCE: • Auto Oriented • Paralegal experience • 18.001 counter affidavit experience • Tier 1 carrier experience • Likes to read/proofread • Excellent legal eyes • Okay with repetitive legal work that demands high-level quality assurance • JOB RELATED SKILLS/COMPETENCIES: • 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. • WORKING CONDITIONS/PHYSICAL DEMANDS: • Any lifting, bending, traveling, etc. required to do the job duties listed above. • Long periods of sitting and computer work. • WORK FROM HOME TECHNICAL REQUIREMENTS: • Supply and support their own internet services. • Maintaining an uninterrupted internet connection is a requirement of all work from home position.

Benefits

• Join our team at Dane Street and enjoy a comprehensive benefits package designed to support your well-being and peace of mind. • We offer a range of benefits including medical, dental, and vision coverage for you and your family. • Additionally, we offer voluntary life insurance options for you, your spouse, and your children. • We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. • Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. • Our generous paid time off policy ensures you have time to relax and recharge, while our 401k plan with a company match helps you plan for your future. • Apple equipment and a media stipend are provided for remote workspace. • ABOUT DANE STREET: • A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful forward-thinking professionals. • We process over 200,000 insurance claims annually.