同行/档案审核质量分析师
Peer/Record Review Quality Analyst
职位概述
Peer / 记录评审质量分析师负责管理医疗文件评审过程的各个方面。他们将审查已完成的转介，以确保客户的问题得到适当处理，并审查已完成的报告以确保准确性。确保符合客户和部门的标准。
Dane Street的成功依赖于每天个人和团队的贡献。我们关心我们的客户、彼此以及Dane Street。我们每个人都有责任维护一个积极的工作环境，促进客户满意度和成果。
主要职责与任务
质量审计
- 审查随附的医疗记录的报告，确保报告完整，并且客户提出的所有问题都已得到解答。
- 如有需要，与评审人员进行后续沟通以获取额外的问题或澄清。
- 如果客户有其他问题，需进行后续沟通。
- 频繁更新客户关于转介的进展。
- 确保报告语法正确，没有拼写错误。
- 在完成前确保每个转介都符合QA检查清单。
- 格式化报告以供批准。
沟通
- 在客户、评审人员和运营团队之间清晰简洁地沟通。
- 必须能够自信地与医生和客户讨论其同行评审的内容。
其他职责和特殊项目，根据业务需求分配。
要求
教育/资质：
优先考虑获得副学士学位或学士学位。
相关工作经验：
优先考虑在医疗保健和/或保险环境中的工作经验。
在商业环境中使用基于技术的流程。
相关技能/能力：
具备出色的沟通能力，清楚了解公司业务线。能够应用批判性思维，高效管理时间并满足特定截止日期。计算机素养和打字技能是基本要求。
工作条件/身体要求：
执行上述职位职责所需的任何搬运、弯腰、旅行等。长时间坐着和使用电脑。
居家办公技术要求：
提供并支持自己的互联网服务。
保持不间断的互联网连接是所有居家办公职位的要求。
本职位描述可能随时更改。
福利
加入Dane Street的团队，享受全面的福利包
查看英文原文
JOB SUMMARY
The Peer / Record Review 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.
Working with technology based processes within the business environment.
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.
This job description is subject to change at any time.
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 family. Additionally, we offer voluntary life insurance options for you, your spouse, and your children. We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. Our generous paid time off policy ensures you have time to relax and recharge, while our 401k plan with a company match helps you plan for your future. Apple equipment and a media stipend are provided for remote workspace.
ABOUT DANE STREET:
A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful forward-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers’ Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We provide customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.
Originally posted on Himalayas