Note: The job is a remote job and is open to candidates in USA. Dane Street is a fast-paced, Inc. 500 Company specializing in processing insurance claims and providing Independent Medical Exams. The Liability IME Operations Specialist is responsible for managing the medical file review and scheduling process, ensuring accuracy and client satisfaction throughout the claims management process.

Responsibilities

• Handling Receipt of New Cases: Intake new cases and review/verify information and requests. Draft cases by entering information into the Dane Street system, AccessDS
• Work with the client on any information missing that is pertinent to processing the claim
• Sort, organize, and create a medical document listing if required by the client and in accordance with specific special handling
• Assignment of Cases: 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
• Oversight of Cases: Monitor, process, and track cases to ensure we meet deadlines
• Quality Audits Review reports accompanying medical records to ensure that the report is complete and that all questions posed by the client have been addressed
• Follow up with the reviewer with any additional questions or clarification needs
• Follow 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
• Format reports for approval
• Communication Communicate clearly and concisely between the customer, reviewer, and Operations team
• Must confidently speak with physicians and clients regarding the content of their IME/record reviews
• 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

Skills

• An Associate's Degree or Bachelor's Degree is preferred
• Business experience in a healthcare and/or insurance setting is preferred
• Operations experience with working with technology based processes within the business environment
• 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
• Supply and support their own internet services
• Maintaining an uninterrupted internet connection is a requirement of all work from home position

Benefits

• Medical, dental, and vision coverage for you and your family
• Voluntary life insurance options for you, your spouse, and your children
• Other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans
• Basic life insurance, short-term disability, and long-term disability coverage at no cost
• Generous paid time off policy
• 401k plan with a company match
• Apple equipment and a media stipend are provided for remote workspace

Company Overview