Physician Advisory Services QA Specialist

Dane Street; United States; On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

401(k) plan with company match

Paid time off policy

Apple equipment and media stipend

Job summary

Dane Street is seeking a QA Specialist to ensure quality assurance in the review process. This role involves communication with clients and physicians to deliver accurate and timely reports. Major duties include evaluating physician reports, providing feedback, and overseeing team member work. Candidates should have preferred education in healthcare/insurance and possess exceptional communication skills. Remote work is supported with necessary technical requirements. Comprehensive benefits including medical, dental, and vision coverage are offered.

Qualifications

• Preferred business experience in a healthcare and/or insurance setting.
• Ability to apply critical thinking and manage time efficiently.
• Maintaining an uninterrupted internet connection is required.

Responsibilities

• Communicate with clients regarding report status updates.
• Evaluate physician's reports for quality and standards.
• Review reports for data accuracy including spelling and grammar.
• Provide oversight to team members as needed.

Skills

Exceptional communication skills

Critical thinking

Computer literacy

Time management

Education

Associate’s Degree or Bachelor’s Degree

Job description

Job Summary

The QA Specialist plays an integral role in the review process as they are responsible for communicating with the customer, reviewer, and management to ensure a completed report is delivered by the customer requested due date. The QA Specialist is responsible for the timely completion and overall completeness of a reviewer report. Completeness is determined by customer requirements, company best practices, and clinical accuracy. In addition, the QA Specialist participates in improving DS processes and works with the Manager to ensure high efficiencies are achieved and that 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

Client Interaction

• Provides regular report status updates to the client
• Evaluates the quality of physician's report and determines if it will meet all client and jurisdictional standards; ensures that the clinical rationale supports the physician’s determinations
• Clarifies ambiguous report questions with clients
• Distributes final report back to client according to client specific requirements
• Receives, coordinates, and executes all aspects of clarification & addendum requests from the client
• Participates in phone calls or meetings with client(s) when a report is in question
• Follows up with the client for any missing information that is pertinent to the referral

Physician Interaction

• Works directly with physicians to ensure that all client questions are answered and supported by clinical rationale
• Conducts regular follow‑up with the physician or their office staff to ensure an on‑time delivery of the report
• Composes and provides verbal or written feedback to the doctor regarding report quality
• Composes and provides verbal or written requests to the physician or their office staff for clarifications
• Receives written or verbal confirmation from the physician that a report has the doctor’s approval and ensures the doctor provides his/her signature for the final report

Report Analysis

• Reviews each physician report for data accuracy including spelling, grammar & punctuation
• Ensures all state requirements for reporting are met
• Ensures report format and adherence to each client’s specific requirements
• Ensures all client special handling instructions with regard to report completion and delivery are met

Additional Duties

• May provide oversight to the work of the team members
• Continuously improves processes that help to facilitate better turnaround time, peer‑to‑peer success rates, and lessens returned reports by clients for clarification purposes, ultimately resulting in higher client satisfaction
• Responsible for the final approval on cases for release to the client
• Acts as a liaison and coordinates quality issue reports along with all new reviewer reports with the VP of Clinical Operations

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.

Job Related Skills/Competencies: Exceptional communication skills with a clear understanding of company business lines; 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: Supplies and supports own internet services; maintaining an uninterrupted internet connection is required.

Benefits

• Medical, dental, and vision coverage for employee and family
• Voluntary life insurance options for employee, spouse, and children
• Other voluntary benefits including hospital indemnity, critical illness, accident indemnity, and pet insurance plans
• Basic life insurance, short‑term disability, and long‑term disability coverage at no cost
• Paid time off policy; 401(k) plan with company match
• Apple equipment and media stipend provided for remote workspace

This job description is subject to change at any time.