New York Workers' Compensation Report Reviewer / Quality Analyst

Dane Street; United States; Remote; USD 50,000 - 70,000; Full time

Benefits offered by this job

Comprehensive benefits package

401k plan with company match

Paid time off

Apple equipment for remote workspace

Job summary

A leading Workers' Compensation service provider is seeking a Quality Analyst to manage the medical file review process, ensuring accuracy and adherence to standards. The position requires exceptional communication skills and business experience, preferably in a healthcare or insurance setting. The role involves reviewing reports, following up with clients, and maintaining quality checks. The company offers a comprehensive benefits package, including medical, dental, and vision coverage, along with a generous paid time off policy and 401k matching.

Qualifications

• Preferred experience in a healthcare and/or insurance setting.
• Working with technology-based processes in a business environment.

Responsibilities

• Manage medical file review process ensuring accuracy and completeness.
• Review and follow up on reports for quality audits.
• Communicate clearly with clients and team members.

Skills

Exceptional communication skills

Critical thinking

Time management

Computer literacy

Typing skills

Education

Associate's Degree or Bachelor's Degree

Job description

New York Workers' Compensation Report Reviewer / Quality Analyst

Job Summary

The New York Workers' Compensation 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. 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

Business experience in a healthcare and/or insurance setting is preferred. Working with technology based processes within the business environment.

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 for leading national and regional Workers' Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We provide customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.