Remote Disability Claims QA Specialist (LTD/STD)

Dane Street; United States; A distancia; USD 60.000 - 80.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health insurance

Retirement plans

Performance bonuses

Apple equipment and media stipend for远

Descripción de la vacante

Dane Street is seeking a Disability Claims QA to join our team, specializing in Long Term Disability (LTD) and Short-Term Disability (STD). You will review reports accompanying medical records and ensure accuracy and completeness, communicating with physician reviewers to clarify information and meet client deadlines.

Responsibilities include assessing physician reports for standards, verifying support for determinations, applying policy guidelines, and providing high-quality QA across cases.

Formación

• 5+ years of claims experience, preferred.
• Disability experience required.
• Business experience in a healthcare and/or insurance setting is preferred.
• Must work with a sense of urgency and meet deadlines.
• Must be self-motivated, with a strong drive for performance excellence.
• Excellent written and verbal communication skills are required.
• Proficiency in navigating a variety of computer programs (Experience with Google Chrome, Gmail, Docs, Sheets, etc. is a plus).
• Attention to detail REQUIRED.

Responsabilidades

• Assess the quality of physician reports, ensuring they meet client and jurisdictional standards specific to long-term disability claims.
• Verify that the claims support the physicians determinations in long-term disability claims.
• Read and apply policy guidelines and healthcare terminology, determining when criteria for long-term disability are met.
• Provide strong customer service by working closely with clients on a case-by-case basis to deliver complete, timely, and error-free quality assurance for long-term disability cases.
• Manage and provide oversight for complex long-term disability cases requiring additional review prior to returning to the client.
• Serve as an additional level of QA for cases with quality issues, utilizing clinical claims knowledge specific to long-term disability.
• Participate in other duties and special projects, as assigned, based on business needs.

Conocimientos

Attention to detail

Communication skills

Time management

Computer literacy

Typing skills

Educación

Associate’s Degree

Bachelor’s Degree

Herramientas

Google Chrome

Gmail

Docs

Sheets

Descripción del empleo

Dane Street is seeking a Disability Claims QA to join our team, specializing in Long Term Disability (LTD) and Short-Term Disability (STD). You will review reports accompanying medical records and ensure accuracy and completeness, communicating with physician reviewers to clarify information and meet client deadlines.

Responsibilities include assessing physician reports for standards, verifying support for determinations, applying policy guidelines, and providing high-quality QA across cases.