Disability Claims QA Specialist

Dane Street, LLC

3d•Remote

About The Position

Dane Street is seeking a Disability Claims QA Specialist specializing in Long Term Disability (LTD) and Short-Term Disability (STD). The role reviews reports accompanying medical records for accuracy and completeness, and works with physician reviewers and their teams to clarify information, address questions, and meet client deadlines. The position focuses on quality assurance for long-term disability claims and includes oversight of complex cases and additional review of cases with quality issues. The role requires disability experience, attention to detail, strong communication and critical-thinking skills, and the ability to manage time and meet deadlines. The position involves long periods of sitting and computer work. For work from home, employees must supply and support their own internet service and maintain an uninterrupted connection. Apple equipment and a media stipend are provided for the remote workspace. Beginning compensation depends on the candidate’s experience, education, and specific skills. Dane Street describes itself as a fast-paced, high-performance company that processes more than 200,000 insurance claims annually and provides customized independent medical exams and peer review programs.

Requirements

Disability experience is required.
Must work with a sense of urgency and meet deadlines.
Must be self-motivated and driven to achieve performance excellence.
Excellent written and verbal communication skills are required.
Attention to detail is required.
Ability to apply critical thinking, manage time efficiently, and meet specific deadlines.
Computer literacy and typing skills are essential.
Must supply and support own internet service for work from home and maintain an uninterrupted connection.
Long periods of sitting and computer work are required.

Nice To Haves

An associate’s or bachelor’s degree is preferred.
Five or more years of claims experience is preferred.
Business experience in a healthcare and/or insurance setting is preferred.
Experience with Google Chrome, Gmail, Docs, Sheets, and similar programs is a plus.

Responsibilities

Assess physician reports for quality and compliance with client and jurisdictional standards for long-term disability claims.
Verify that claims support physicians’ determinations in long-term disability cases.
Read and apply policy guidelines and healthcare terminology to determine when long-term disability criteria are met.
Work with clients case by case to deliver complete, timely, and error-free quality assurance for long-term disability cases.
Manage and oversee complex long-term disability cases that require additional review before they are returned to the client.
Provide an additional level of quality assurance for cases with quality issues, using clinical claims knowledge specific to long-term disability.
Participate in other duties and special projects as assigned based on business needs.

Benefits

Health insurance, including medical, dental, and vision coverage for employees and their families.
Retirement plan with a company match.
Performance bonuses.
Voluntary life insurance options for employees, spouses, and children.
Voluntary hospital indemnity, critical illness, accident indemnity, and pet insurance plans.
Basic life insurance at no cost to employees.
Short-term disability coverage at no cost to employees.
Long-term disability coverage at no cost to employees.
Paid time off.
Apple equipment and a media stipend for the remote workspace.