Group Health Quality Analyst 1 (Nights)
New
D
Dane StreetHealthcare Insurance
United StatesFull-TimeEntry
Salary not disclosed
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Job Details
- Required Skills
- Quality Assurance
Requirements
- Active LPN or RN license required.
- Associate’s or Bachelor’s Degree preferred.
- Business experience in a healthcare and/or insurance setting preferred.
- Exceptional communication skills with understanding of company business lines.
- Strong critical thinking and time management abilities.
- Computer literacy and typing skills.
- Must supply and support own internet services.
- Ability to maintain an uninterrupted internet connection.
Responsibilities
- Provide regular report status updates to the client.
- Evaluate the quality of physician reports against client and jurisdictional standards.
- Clarify ambiguous questions with clients and coordinate addendum requests.
- Work directly with physicians to ensure clinical rationale supports determinations.
- Follow up with physicians to ensure on-time delivery and obtain necessary approvals and signatures.
- Review reports for data accuracy, including spelling, grammar, and punctuation.
- Ensure compliance with state reporting requirements and client-specific handling instructions.
- Act as a liaison for quality issues with the VP of Clinical Operations.
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