New York Quality Analyst

Quality Analyst

Employment Type: Full-time

Location Type: Remote

Position Overview

The Quality Analyst is responsible for managing the various aspects of the medical file review process. They will review completed referrals to ensure client questions have been addressed appropriately and review completed reports 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 of all employees to maintain a positive working environment that promotes client satisfaction and results.

Major Duties & Responsibilities

Quality Audits

• Reviews reports accompanying medical records to ensure the report is complete and all client questions have been addressed.
• Follows up with the reviewer for any additional questions or clarifications needed.
• 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 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

• Other duties and special projects, as assigned and based on business needs.

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.
• NY Workers Compensation experience is preferred.
• Operations experience with Peer Review, UR and/or case management.
• Working with technology-based processes within the business environment.

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.
• Ability to handle high volume and meet deadlines.

Working Conditions/Physical Demands

• May involve lifting, bending, and traveling as required for job duties.
• Includes long periods of sitting and computer work.

Work From Home Technical Requirements

• Must supply and support their own internet services.
• Maintaining an uninterrupted internet connection is a requirement for all work-from-home positions.

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:

• Medical, dental, and vision coverage for you and your family.
• Voluntary life insurance options for you, your spouse, and your children.
• Other voluntary benefits including hospital indemnity, critical illness, accident indemnity, and pet insurance plans.
• Company-provided basic life insurance, short-term disability, and long-term disability coverage at no cost.
• Generous paid time off policy.
• 401k plan with a company match.
• Apple equipment and a media stipend are provided for remote workspace.

About Dane Street

Dane Street is a fast-paced, Inc. 500 Company with a high-performance culture, 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.

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This job description is subject to change at any time.