Dane Street

QA Engineer

• The QA Specialist plays an integral role in the review process as they are responsible for communicating with the customer, reviewer, and management to ensure a completed report is delivered by the customer requested due date.
• The QA Specialist is responsible for the timely completion and overall completeness of a reviewer report. Completeness is determined by customer requirements, company best practices, and clinical accuracy.
• In addition, the QA Specialist participates in improving DS processes and works with the Manager to ensure high efficiencies are achieved.
• Provides regular report status updates to the client.
• Evaluates the Quality of physician’s report and determines if the report will meet all client and jurisdictional standards; the QA Specialist is also responsible for ensuring that the clinical rationale supports the physician’s determinations.
• Clarifies ambiguous report questions with clients.
• Distribute final report back to client according to client specific requirements.
• Receives, coordinates & executes all aspects of clarification & addendum requests from the client.
• Participates in phone calls OR meetings with client(s) when a report is in question.
• Follow up with the client for any missing information that is pertinent to the referral.
• Works directly with physicians to ensure that all client questions are answered and supported by clinical rationale.
• Conduct regular follow up with the physician or their office staff to ensure an on-time delivery of the report.
• Compose and provide verbal or written feedback to the doctor regarding report quality.
• Compose and provide verbal or written requests to the physician or their office staff for clarifications.
• Receive written or verbal confirmation from the physician that a report has the doctor’s approval and ensures the doctor provides his/her signature for the final report.
• Review each physician report for data accuracy including spelling, grammar & punctuation.
• Responsible for ensuring that all state requirements for reporting are met.
• Responsible for report format and adhering to each client’s specific requirements.
• Must ensure that all client special handling instructions with regard to report completion and delivery are met.
• May provide oversight to the work of the team members.
• Continuously improves processes that help to facilitate better turnaround time, peer to peer success rates and lessens returned reports by clients for clarification purposes, ultimately resulting in higher client satisfaction.
• Responsible for the final approval on cases for release to the client.
• Will act as a liaison and coordinate quality issue reports along with all new reviewer reports with the VP of Clinical Operations.

Physician Advisory Services – QA Specialist

Customer Support

• 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 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.
• Oversight of Cases:
• Monitor, process and track cases to ensure we meet deadlines.
• 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 assignments
• Client Interaction:
• 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.

Group Health Customer Service Representative

Account Manager

• Identify and pursue new revenue opportunities within existing and new accounts • Working with Dane Street’s Director of Operations, QA Staff and Business Analyst team to ensure client satisfaction and effective problem resolution • Developing strong Manager/Requester and Senior Leadership relationships across Dane Street’s accounts • Generating strong goodwill within the existing account user base • Creating and executing a strategic account plan for all Dane Street clients • Growing revenue and referral volume within all top target accounts • Proactively identify risks and resolve client concerns • Conduct outreach to prospective clients through networking, referrals and targeted prospecting • Provide weekly reporting on account health, growth opportuniries and sales activities • Support special projects and cross-functional initiatives as needed

Disability National Account Manager

• 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.
• Monitor, process, and track cases to ensure we meet deadlines.
• Update clients frequently on cases in progress.

Customer Service Representative

Auditor

• **MAJOR DUTIES & RESPONSIBILITIES**
• - Onboard and train all new QA hires.
• - New QAs will be ready for integration into the ops team when the following criteria are met
• - Collaborate on the review of daily operational reports (e.g., outcome reports, TAT, operational synopsis, employee goals).
• - Serve as a resource for team members regarding operational questions, concerns, and problem-solving.
• - Provide backup support to QA Supervisors as needed (e.g., invoicing, board balance).
• - Maintain weekly clarification tracker; identify QAs with opportunities for additional training or feedback.
• - Participate in client calls.
• - Lead bi-weekly Clarification/TAT review meetings: pull data, facilitate discussions, and issue remediation plans.
• - Conduct regular MFR (member-friendly rationale) Workshop training sessions.
• - Develop onboarding agendas in consultation with Ops Leadership.
• - Identify and schedule training opportunities/meetings.
• - Coordinate and track annual client regulatory training requirements.
• - Update and maintain severity and client-change trackers.
• - Create and maintain training documentation.
• - Collaborate on remediation plans for employees.
• - Provide reviewer training when a Medical Director is unavailable; escalate issues to Medical Directors when appropriate.
• - Partner with managers and supervisors to support 90-day reviews, annual evaluations, and PIPs.
• Performance Metrics:
• - Audit Success: Measured by clarification rates, audit results, and daily/monthly TAT.
• - Remediation Effectiveness: Measurable performance improvement within defined timelines
• - Training Success: Evaluated through 90-day and annual employee reviews, and check-ins with new hires (daily, weekly, monthly).
• Other duties & special projects, as assigned and based on business needs.
• ****

Physician Advisory Services Trainer – Auditor

• The Workers Comp CSR Supervisor is responsible for managing the various aspects of the medical file review process, specifically the intake, turn-around time and the supervision of the Customer Service Representative team.
• Oversight of Case Handling
• - Oversight of File Review to ensure that cases are properly notated and are processed timely.
• - Provide guidance on cases where there are questions on assignment and process handling.
• - Conduct monthly audits on staff to ensure that goals are met and coaching/training is provided when required.
• - Provide guidance and resolution to issues brought to the attention of the supervisor.
• Coaching
• - Train new team members on case workflow, processes and client specific requirements.
• - Conduct one on one meetings with staff for progress meetings and to provide feedback.
• - Participate in writing initial and annual reviews of staff members. May provide input into the hiring & firing process.
• Client Interaction
• - Provides updates to clients frequently on cases in progress.
• - Responds to clients when there are questions on referral information to ensure proper documentation and information is provided to the assigned reviewer.
• - Ensure proper documentation for complex cases is provided to the client.
• - Provide exceptional customer service to clients. ********

Customer Service Supervisor

Operations

• Supervise daily operations of the disability claims team to ensure efficient workflow and quality outcomes.
• This includes case assignments and performance management.
• Oversight of the scheduling, quality assurance and/or admin functions.
• Train, mentor, and develop team members to achieve individual and team goals.
• Drive client satisfaction by ensuring all client inquiries and communications are addressed timely.
• Monitor and assess team performance against established KPIs and metrics.
• Identify areas for process improvement and implement action plans.
• Collaborate with other departments to enhance operational efficiencies.
• Maintain accurate records and documentation as required by company policy and regulatory standards.
• Prepare reports on team performance and present to management.
• Other duties as assigned.

Disability Operations Supervisor

Financial Planning and Analysis

• The Senior Accountant plays a crucial role in supporting the daily, monthly, and annual activities of the finance department.
• The Sr. Accountant should possess strong analytical and problem-solving skills, be detail-oriented, have solid conceptual thinking, and be able to apply these traits to large datasets.
• This role requires hands-on experience with general ledger accounting, ERP systems, and financial reporting.
• Hybrid work arrangement (1 day remote per week) may be available after successful completion of a 3-month probationary period, based on business needs.

Finance Manager

Accountant

• The Senior Accountant plays a crucial role in supporting the daily, monthly, and annual activities of the finance department. The Sr. Accountant should possess strong analytical and problem-solving skills, be detail-oriented, have solid conceptual thinking, and be able to apply these traits to large datasets. This role requires hands-on experience with general ledger accounting, ERP systems, and financial reporting.
• Dane Street’s success relies on individual and team contributions every day. We care for our customers, each other, and Dane Street. It’s the responsibility of all of us to maintain a positive working environment that promotes client satisfaction and results.
• Hybrid work arrangement (1 day remote per week) may be available after successful completion of a 3-month probationary period, based on business needs.

Corporate Accountant

• Oversee and ensure the overall profitability of the regional operations center
• Reach and exceed financial & referral goals
• Properly manage staffing efficiencies throughout the team
• Manage performance expectations & improvements for existing staff
• Present management with regular reporting on any topic requested by the management team
• Plan and organize daily activities related to production and operations
• Measure productivity by analyzing performance data, financial data, and activity reports
• Coordinate with other support departments such as human resources, finance, IT and BA
• Determine labor needs to meet production goals
• Hire and train new employees
• Organize and oversee the schedules and work of assigned staff
• Conduct performance evaluations that are timely and constructive
• Handle discipline and termination of employees as needed
• Oversee the deposition process at the request of the client or defense counsel