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By | July 23, 2022

Job Responsibilities : Quality Review Nurse

Salary : $61000 per year

Company : DANE STREET LLC

Location : Remote US

Educational requirements : Graduate

Dane Street is looking for highly motivated candidates to join our team as a Clinical Quality Assurance Specialist. Dane Street offers an exciting work environment competitive compensation and a strong growth potential.

Job Summary:

As a Clinical Quality Assurance Specialist you will review reports accompanying medical records to ensure that the report is complete. You will communicate with physician reviewers and their office teams to ensure clarity of information and to ensure all questions posed have been addressed and to ensure that reports are returned within client deadlines.

Shifts Available Are:

**Monday-Friday 9am to 5:30pm EST**

**Monday-Friday 12pm to 8:30pm EST**

**Monday-Friday 1pm to 9:30pm EST**

Core Duties & Responsibilities:

  • Evaluates the quality of the physician’s report and determines if the report will meet all client and jurisdictional standards.
  • Ensures that the clinical rationale supports the physician’s determinations.
  • Read & apply policy guidelines healthcare terminology and delineate when criteria is/is not met.
  • Provides strong customer service skills and works closely with clients on a case-by-case basis to provide complete timely and error free quality assurance of cases.
  • Provides clinical oversight to cases that are complex and need additional review prior to return to the client.
  • Serves as an additional level of QA and clinical knowledge/review for cases with quality Issues.

Required Education & Experience:

  • Must be a graduate of an accredited LPN LVN or RN program.
  • Utilization Management experience is strongly preferred.
  • Experience working in a remote environment is preferred.
  • Experience in a medical office or health care background.

Required Skills:

  • 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.

Benefits

We offer generous Paid Time Off excellent benefits package and competitive salary. If you are an outstanding candidate for this position if you thrive in a fast-paced environment and if you are interested in doing meaningful work that impacts others’ lives then we encourage you to apply.

ABOUT DANE STREET (www.danestreet.com):

A fast-paced Inc. 500 Company with a high-performance culture Dane Street is seeking insightful astute forward-thinking professionals. We process over 200000 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.

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