Dane Street, LLC

Dane Street, LLC is a healthcare company that specializes in providing quality assurance and clinical services, particularly in the area of long-term disability. They leverage advanced technologies to enhance their operations.

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Jobs at this company:

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🔥 Board Certified Orthopedic Hand Surgery Physician Reviewer - California License

Posted about 18 hours ago

🧭 Contract

🔍 Healthcare

🔧 Requirements

Current, unrestricted California Medical License
Board Certified in Orthopedic Surgery - Hand
Experience in the California Independent Medical Review (IMR) process

💡 Responsibilities

Conduct advisory-only medical reviews
Choose services and case types
Dictate volume
Evaluate medical necessity based on established standards
Clearly articulate rationale in written determinations

Posted about 18 hours ago

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🔥 Board Certified Neurological Surgery Physician Reviewer - California License

Posted about 18 hours ago

🧭 Contract

Posted about 18 hours ago

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🔥 Board Certified Occupational Medicine Physician Reviewer - California License

Posted about 18 hours ago

📍 California, United States

🧭 Contract

🔍 Occupational Medicine

🔧 Requirements

Current, unrestricted California Medical License
Board Certified in Occupational Medicine
Experience in the California Independent Medical Review (IMR) process
Expertise in the Medical Treatment Utilization Schedule (MTUS)
Expertise in Official Disability Guidelines (ODG)
Expertise in medicolegal writing

💡 Responsibilities

Conduct medical reviews
Assess medical necessity based on established standards
Clearly articulate rationale in written determinations

Posted about 18 hours ago

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🔥 PRN Utilization Review Nurse Reviewer - Immediate Hiring

Posted 11 days ago

📍 United States

🧭 Part-Time

🔍 Healthcare

🔧 Requirements

Unrestricted LVN/RN license
2+ years clinical nursing experience
1 year experience in Utilization Management
Proficient in Microsoft Word, Excel, PowerPoint, and Outlook

💡 Responsibilities

Conduct assessments of medical services for appropriateness
Examine patient records for quality of care
Provide clinical expertise for non-clinical staff

Microsoft AccessMicrosoft Excel

Posted 11 days ago

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🔥 Board Certified - California Licensed Physician Reviewers-Multiple Specialties

Posted 15 days ago

📍 United States

🧭 Contract

🔍 Healthcare

🔧 Requirements

Current, unrestricted California Medical License
Board Certified
Active Practice

💡 Responsibilities

Conduct medical necessity reviews for treatment requests
Respond to appeals regarding denied services
Participate in peer-to-peer communications when necessary

Posted 15 days ago

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🔥 Reporting Analyst

Posted 15 days ago

📍 United States

🔍 Insurance

🔧 Requirements

A minimum of 2-3 years of experience in related roles or equivalent education expected for this position.
PC/MAC proficiency, including experience with MS Office, Excel and MS Project.
Business experience in a healthcare and/or insurance setting is preferred.
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.
Detail oriented, strong organization, prioritization and time-management skills.
Excels in attention to detail with a high level of accuracy.
Works well under pressure and is able to accomplish multiple tasks, with conflicting priorities and timelines.
Excellent oral and written communication skills, proven analytical skills, strong problem-solving skills and highly developed interpersonal skills.
Ability to track and report progress on a wide range of tasks, simultaneously.
Ability to respond to and deal with a range of ad hoc queries/requests.
Ability to operate with discretion and confidentiality at all times.
Maintains flexibility in approach and adjusts actions when appropriate.

💡 Responsibilities

Complete all internal and client driven reporting/analytic requests.
Interpret data, analyze results using statistical techniques and provide ongoing reports.
Provide trends in data that could help improve business procedures and practices.
Provide feedback on technology enhancements that could improve analytic tracking.
Ensure that all data is operationally accurate and appropriate for client distribution.
Meet monthly deadlines of sales and client driven due times of all reporting.
Provide support to sales in both internal and client calls to help review data provided
Assist with intake boards to ensure communications posted are assigned to the appropriate persons for handling in a timely manner.
Follow proper escalation processes to ensure proper customer service.
Act as liaison between the business and technology when requests related to analytics are requested to bridge the gap between knowledge of client requests and technology capabilities.
Communicate with appropriate internal contacts and supervisor/manager for completion of projects/reports and timely delivery to the final recipients.
Develop and maintain appropriate documentation in the form of business and functional requirements, status updates, estimates, and other materials, as requested by client and/or Manager.
Support all internal business leadership in a subject-matter-expert capacity, as needed
Work alongside teams within the business or the management team to establish business needs.
Adapt to different internal / operational dynamics and team dynamics as appropriate to each situation. This adaptability includes the need to accept tasks that may not regularly be associated with this role and to shift priorities as requested.
Work closely with business teams to review, verify, and confirm data integrity and accuracy for all hr internal and external data requests.
Other duties & special projects, as assigned and based on business needs.

Posted 15 days ago

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🔥 Group Health Medical Director

Posted 16 days ago

📍 United States

🧭 Contract

🔍 Health Care

🔧 Requirements

Board Certified M.D. or D.O.
Current, unrestricted clinical license in any State in the U.S.
Working knowledge of URAC and compliance guidelines
Experience in Utilization Management

💡 Responsibilities

Perform quality assurance training and audits
Serve as clinical lead for the Group Health Department
Assist with quality assurance of reports
Perform random case audits
Oversee the credentialing of physician advisors

Communication SkillsCritical thinkingQuality Assurance

Posted 16 days ago

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🔥 IME Customer Service Representative

Posted 18 days ago

📍 United States

🔍 Healthcare, Insurance

🔧 Requirements

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.
Business experience in a healthcare and/or insurance setting is preferred.

💡 Responsibilities

Intake new cases and review/verify information and requests.
Draft cases by entering information into the Dane Street system, AccessDS.
Work with client on any information missing pertinent to processing claim.
Sort, organize and create medical document listing - if required by client, and in line with specific special handling.
Assign/schedule new cases to physicians for review with the appropriate physician, based on location, reviewer availability, specific guidelines, jurisdictional requirements and other client requirements.
Ensure that the assigned physician has no conflict of interest with the case assignment.
Monitor, process and track cases to ensure we meet deadlines.
Update clients frequently on cases in progress.
May communicate when there are questions on referral information to ensure proper documentation and information is provided to the assigned reviewer.
Ensure proper documentation for specified cases is provided to the client.
Other duties & special projects, as assigned and based on business needs.

Posted 18 days ago

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🔥 Optometry Record Reviewer (Only apply if you live in CT)

Posted about 1 month ago

📍 United States

🔍 Optometry

🔧 Requirements

Must be a board-certified Optometrist.
Prior experience in record review is preferred but not required.
Strong analytical skills.
Attention to detail.
Effective communication abilities.

💡 Responsibilities

Thoroughly analyze and assess patient medical documentation related to optometry.
Offer specialized opinions on treatment plans, diagnoses, and ongoing care based on recorded patient history.
Create detailed reports summarizing findings and recommendations with a prompt turnaround.

Analytical SkillsAttention to detailWritten communication

Posted about 1 month ago

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🔥 Medical & Billing Coder - Texas

Posted about 1 month ago

📍 United States

🔍 Healthcare and Insurance Services

🔧 Requirements

Must have a CPC, APCC, or DRG coder certification.
Payment integrity or professional bill review experience preferred.
Out-of-network bill review experience is a plus.
Experience in a remote environment preferred.
Must have access to billing references/engine.
Extensive knowledge of Texas billing resources is preferred.
CPC, CCS, or CCA certification is preferred but not required.
Deposition/Testimony experience is preferred but not required.

💡 Responsibilities

Evaluates the appropriateness of codes and ensures they meet established program standards.
Ensures medical records are correctly matched to codes and obtains them if necessary.
Applies policy guidelines and healthcare terminology to assess criteria compliance.
Evaluates claims for conflicts of interest and appropriateness.
Works within defined timeframes set by program parameters.
Provides customer service and collaborates with clients for quality assurance.
Offers clinical oversight for complex cases needing additional review.

Posted about 1 month ago

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