Quality Analyst - Washington L&I

JOB SUMMARY

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

MAJOR DUTIES & RESPONSIBILITIES

Quality Audits

• Reviews reports accompanying medical records to ensure that the report is complete and that all questions posed by the client have been addressed.
• Follows up with the reviewer with any additional questions or clarifications needs.
• 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 the 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 & special projects, as assigned and based on business needs.

Requirements

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.
• Operations experience with Peer Review, UR and/or case management.
• Working with technology based processes within the business environment.
• Washington L&I experience required.

JOB RELATED SKILLS/COMPETENCIES:

Present exceptional communication skills with a clear understanding of company business lines. The ability to apply critical thinking, manage time efficiently and meet specific deadlines. Computer literacy and typing skills are essential.

WORKING CONDITIONS/PHYSICAL DEMANDS:

Any lifting, bending, traveling, etc. required to do the job duties listed above. Long periods of sitting and computer work.

WORK FROM HOME TECHNICAL REQUIREMENTS:

Supply and support their own internet services.

Maintaining an uninterrupted internet connection is a requirement of all work from home position.

Compensation Range: $41,000 USD - $61,500 USD

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 a range of benefits including medical, dental, and vision coverage for you and your …