Workers Compensation Claims Analyst
Dane Street, LLC, United States

Dane Street is looking for highly motivated candidates to join our National IME (Independent Medical Examination) as a ClaimsQuality Analyst (internally known as Quality Analyst). Dane Street is proud to be Great Place to Work-Certified and offers an exciting work environment, competitive compensation and a strong growth potential.

A Quality Analyst is in the center of our critical relationships with our clients, our technical team and our operations teams. As a member of our team, you will be responsible for reviewing IME and Peer Review reports for accuracy.

Do you thrive in a fast paced environment? You are the right person if you have exceptional communication skills, display attention to details, the ability to apply critical thinking and are able to manage time effectively while meeting specific deadlines.

Description of Key Tasks and Responsibilities:

• Reviews reports accompanying medical records to ensure that the report is complete and that all questions posed have been addressed.
• Follows up with the reviewer and clients with any additional questions or need clarification.
• Evaluate physician specialty assignment and guidelines application based on guidelines or assist in the analysis of IME cases.
• Communicate inconsistencies and/or inaccuracies based on medical documentation and/or state guidelines.
• Follows up with IME/Peer Review provider to ensure that the report is received back for QA within the specified time-line set forth by the referrer.
• Improve team's competence by providing resources; balancing file requirements within the client specifications all within company procedures and guidelines.

Requirements

Required Education and Experience:

• An Associate’s Degree or Bachelor’s Degree is preferred.
• Lost Time Workers Compensation claims experience is preferred.
• Previous experience with peer review/case management is preferred.
• Experience as a claims adjuster within the insurance/medical industry, auto, worker's compensation, nursing (LPNs or RNs) or work with an IME company a plus.

Special Skills and Attributes:

• Ability and confidence to speak with physicians and clients regarding the content of their medical peer reviews.
• Claims/Medical Terminology background.
• Ability to learn quickly.
• Ability to research and document clearly is essential to the success of this position.
• Excellent computer skills are required.
• Excellent organizational skills are essential, including the ability to manage time efficiently and to meet specific deadlines.
• Excellent communication and grammar skills are a must.
• The ability to work independently and make critical decisions is essential.

Benefits

We offer generous Paid Time Off, excellent benefits package and a competitive salary. Apple equipment and media stipend is provided for remote work space. Come up to speed quickly with our strong training program! If you want to work in an exciting, fast-paced environment where you can provide meaningful contributions, then we encourage you to apply.

ABOUT DANE STREET:

A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful, astute 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 Exam and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.

Job Rewards and Benefits