Disability Claims QA Specialist
New
D
Dane StreetDisability claims
Workable workplace: remote; Workable locations: United StatesFull-TimeSenior
Salary not disclosed
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Job Details
- Experience
- 5+ years of claims experience, preferred.
- Required Skills
- Google SheetsCritical thinking
Requirements
- Disability experience is required.
- 5+ years of claims experience is preferred.
- Business experience in a healthcare and/or insurance setting is preferred.
- An associate’s or bachelor’s degree is preferred.
- Demonstrate attention to detail.
- Use critical thinking and manage time efficiently to meet specific deadlines.
- Have computer literacy and typing skills.
- Navigate computer programs; experience with Google Chrome, Gmail, Docs, and Sheets is a plus.
- Provide excellent written and verbal communication.
- Supply and support your own internet service for work from home, with an uninterrupted internet connection.
Responsibilities
- Assess physician reports for compliance with client and jurisdictional standards for long-term disability claims.
- Verify that claim information supports physicians’ determinations in long-term disability claims.
- 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 accurate quality assurance for long-term disability cases.
- Communicate with physician reviewers and their teams to clarify information, address questions, and meet client deadlines.
- Manage and oversee complex long-term disability cases that require additional review before returning them 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.
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