Dane Street

Analyst

• Manage various aspects of the medical file review process, including reviewing completed referrals and reports for accuracy
• Review reports accompanying medical records to ensure completeness and that client questions have been addressed
• Follow up with reviewers for additional questions or clarifications and with clients if further questions arise
• Update clients frequently on referral progress and format reports for approval
• Ensure reports adhere to QA checklist and are grammatically correct with no spelling errors
• Communicate clearly and concisely among the customer, reviewer, and Operations team
• Speak confidently with physicians and clients regarding the content of peer reviews
• Perform other duties and special projects as assigned; maintain a positive working environment
• Work-from-home duties include long periods of sitting and computer work; may require lifting, bending, or travel as needed

Claims Quality Analyst

Therapist

• Utilize clinical expertise to review insurance appeals and prospective and retrospective claims
• Provide interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client specific policies, nationally recognized evidence-based guidelines, and standards of care
• Review all medical records and address each question posed by the client utilizing client specific criteria or other nationally recognized evidence-based criteria
• Ensure the rationale for determinations is clear, concise, and contains adequate supporting documentation
• Identify, critique, and utilize current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature
• Provide copies of any criteria utilized in a review with the report in a timely manner and return cases on or before the due date and time
• Make telephone calls as mandated by the state and/or client specifics
• Maintain proper credentialing and state licenses and any special certifications or requirements necessary to perform the job
• Attend all required orientation and training and perform other duties as assigned (quality assurance, complaints, regulatory issues, depositions, court appearances, audits)

Occupational Therapy, Independent Medical Examiner

Operations

• Provide Physician Reviewer/Advisor services for Independent Medical Exams (IME) reviewing insurance appeals and prospective and retrospective claims
• Interpret medical necessity of services provided by other healthcare professionals in compliance with client-specific policies, evidence-based guidelines, and standards of care
• Review all medical records and address each client question using client-specific criteria or nationally recognized evidence-based criteria
• Ensure determinations include clear, concise rationale with adequate supporting documentation and provide copies of criteria used with reports
• Identify, critique, and utilize current guidelines and peer-reviewed literature to support objective decision-making
• Return cases on or before the due date and time and make required telephone calls
• Maintain credentials and state licenses, attend required training, and perform other duties as assigned (quality assurance, complaints, regulatory issues, depositions, court appearances, audits)

Board-Certified Neuropsychologist, Workers' Compensation IME

Accountant

• Perform complex vendor payment reconciliations and provide explanations to outside parties
• Reconcile prepayments with independent contractors, process refunds, and apply payments to services rendered
• Assist with month-end close activities including balance sheet reconciliations and corrections
• Execute full cycle accounts payable: obtain approvals, record transactions, analyze expenses, process payments, and manage vendors
• Reconcile doctor-related A/P and issue payments based on terms; review unpaid bills, unapplied credits, and uncashed checks
• Manage AP email inquiries: current invoicing, payment research, discrepancies, and open invoices
• Cross-train and support intra-departmental functions (full cycle A/R and A/P tasks, credit card expenses, corporate payables, revenue-offsetting payables)
• Handle other duties and special projects as assigned

Senior Accountant

• Manage medical file review process and review completed referrals to ensure client questions are addressed and reports are accurate
• Review reports accompanying medical records to ensure completeness and that all client questions have been addressed
• Follow up with reviewers for clarifications and with clients for additional questions
• Update clients frequently on referral progress
• Ensure reports are grammatically correct with no spelling errors
• Ensure each referral adheres to the QA checklist prior to completion
• Format reports for approval
• Communicate clearly and concisely between the customer, reviewer, and Operations team
• Speak confidently with physicians and clients regarding the content of peer reviews
• Perform other duties and special projects as assigned based on business needs

IME Quality Analyst, Liability

Customer Support

• Draft incoming referrals including demographic information, diagnosis, requested due date, and specialty in a timely manner.
• Complete the intake process accurately by closing intake according to workflow procedures.
• Filter client emails throughout an 8-hour workday and delegate/escalate to appropriate team members.
• Assist with Dane Street’s Intake to upload incoming referrals, records, and fee schedules into respective cases and notify stakeholders.
• Handle outreach emails/calls to clients to obtain necessary information and medical records for cases.
• Request and pull medical records from client platforms such as iCase and upload them to respective referrals; notify CSR team when records are received.
• Select and assign incoming referrals and ensure queues are evenly distributed between CSRs and QAs.
• Invoice referrals on the CSR and QA board based on confirmed physician fees and client quotes.
• Assist in auditing referrals with upcoming due dates to ensure correct processing.
• Assist with physician outreaches and referral assignments when team members are on PTO.
• Perform other duties and special projects as assigned based on business needs.

Customer Service Administrator

• 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 pertinent to processing the claim
• Sort, organize and create a medical document listing if required by the client
• Monitor, process and track cases to ensure deadlines are met
• Assign/schedule new cases to physicians for review based on location, reviewer availability, guidelines, jurisdictional requirements and client requirements
• Ensure assigned physicians have no conflict of interest with case assignments
• Update clients frequently on cases in progress
• Communicate questions on referral information to ensure proper documentation for reviewers
• Ensure proper documentation for specified cases is provided to the client

Customer Service Representative – Disability

Product Marketing

• Perform independent medical reviews for Pain Management / Interventional Pain Medicine cases
• Review medical records and treatment requests for medical necessity
• Provide objective, evidence-based decisions on appealed or disputed cases
• Deliver detailed, written reports — no direct patient care involved
• Complete all casework securely through Dane Street’s online portal
• Work on a fully remote, flexible schedule; set your own hours and case volume
• Complete onboarding and training (typically within 1 week); meet case deadlines (typically 1–5 business days)

Pain Management Physician, Physician Advisory Reviewer

QA Engineer

• Review and ensure accuracy and completeness of reports accompanying medical records for long-term disability claims
• Assess the quality of physician reports, ensuring they meet all client and jurisdictional standards specific to long-term disability claims
• Verify that the claims support the physicians determinations in long-term disability claims
• Read and apply policy guidelines and healthcare terminology to determine when criteria for long-term disability are met
• Communicate with physician reviewers and their teams to ensure clarity of information and address posed questions
• Provide strong customer service by working closely with clients on a case-by-case basis to deliver complete, timely, and error-free quality assurance for long-term disability cases
• Manage and provide oversight for complex long-term disability cases requiring additional review prior to returning to the client
• Serve as an additional level of QA for cases with quality issues, utilizing clinical claims knowledge specific to long-term disability
• Participate in other duties and special projects, as assigned, based on business needs
• Meet client deadlines and maintain high standards of performance

Quality Assurance Specialist, Clinical RN – Disability

• 100% REMOTE
• JOB SUMMARY
• Oversee and ensure the overall profitability of the regional operations center. This includes but is not limited to reaching and exceeding financial & referral goals, properly managing staffing efficiencies throughout the team, managing performance expectations & improvements for existing staff. Present management with regular reporting on any topic requested by the management team.
• 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
• Driving Revenue Growth
• The Operations Manager drives revenue growth by delivering excellent Customer service.
• This includes meeting scheduling best practices and turnaround time requirements.
• Ensuring the timely delivery of high quality reports.
• Managing client inquiries in a timely manner.
• Optimizing Physician cost
• Ensuring that client invoices adhere to the agreed upon fee schedule.
• Overseeing the proper selection of physicians.
• Specifically ensuring that the team selects the most appropriate physician based on the claimant’s location, the required specialty, and the most appropriately priced physician based on the client’s fee schedule.
• Building relationships with key physicians to ensure panel retention.
• Manage Staff Performance and capacity
• Monitor key performance metrics of individual Customer Service Representatives (CSR) and Quality Assurance (QA) Specialists.
• Ensure the team meets or exceeds 85% of output goals for scheduling and Quality Assurance targets.
• Responsible for hiring new staff members based on increased referral volume and/or the addition of new clients.
• Conducts performance evaluations that are timely and constructive.
• Handles discipline and termination of employees as needed and in accordance with company policy.
• Responsible for the overall production, performance, and quality of the assigned region.
• Plans and organizes daily activities related to production and operations.
• Measures productivity by analyzing performance data, financial data, and activity reports.
• Coordinates with other support departments such as human resources, finance, and IT and BA to ensure successful production operations.
• Determines labor needs to meet production goals.

Group Health Operations Manager, RN/LPN

Recruitment

• Job Summary: The Phyisican Recruiter is responsible for maintaining and expanding Dane Street’s physician panel. This includes negotiating physician fees within pre-established guidelines, onboarding new physicians based on client demand, and ensuring that all open service requests (OSRs) are resolved promptly. The ideal candidate will leverage existing relationships and industry knowledge to strategically grow the network and support business operations.
• Panel Maintenance & Growth: Understand client fee schedules and turnaround time (TAT) requirements to negotiate physician agreement terms.
• Panel Maintenance & Growth: Conduct outreach for refunds or recoupments; collaborate with Finance and Legal when collections are required.
• Panel Maintenance & Growth: Maintain existing physician records, including: Fee updates; W9 and remittance changes; Profile instructions; Doctor groups; Deactivations/reactivations.
• Panel Maintenance & Growth: Research and source new panel options as needed.
• Panel Maintenance & Growth: Onboard new physicians based on client needs.
• Panel Maintenance & Growth: Negotiate rates and contract terms per company guidelines.
• Panel Maintenance & Growth: Collect necessary documentation (agreements, CVs, applications, W9s, NPDB reports).
• Panel Maintenance & Growth: Coordinate with the Director of Operations to finalize fees.
• Special Assignments & Contract Negotiations: Lead contract renegotiations for existing physicians (agreements, pricing changes, special initiatives).
• Special Assignments & Contract Negotiations: Handle complex client requests, especially those involving niche specialties or urgent network gaps.
• Special Assignments & Contract Negotiations: Assist physician reviewers with technical issues or case-specific inquiries.
• Special Assignments & Contract Negotiations: Fulfill high-priority OSRs by recruiting appropriate specialists and providing daily updates on progress.
• Special Assignments & Contract Negotiations: Collaborate with operations to ensure network alignment with business needs.
• Additional Duties: Support other projects and tasks as assigned by leadership.
• Additional Duties: Stay current on industry trends and compliance requirements.
• Qualifications: Education: Associate's or Bachelor's degree preferred.
• Qualifications: 3–5 years of physician recruitment experience in a healthcare or insurance environment.
• Qualifications: Familiarity with provider networks and healthcare operations is strongly preferred.
• Qualifications: Deep understanding of physician recruitment, medical specialties, and related terminology.
• Qualifications: Strong negotiation and communication skills.
• Qualifications: Working knowledge of federal/state healthcare compliance standards.
• Qualifications: Excellent time management, critical thinking, and organizational abilities.
• Qualifications: Proficiency in Microsoft Office and general computer systems.
• Working Conditions: Primarily remote with extended periods of computer work.
• Working Conditions: Occasional lifting, bending, or travel may be required depending on business needs.
• Technical Requirements (Remote Work): Must supply and maintain reliable, high-speed internet.
• Technical Requirements (Remote Work): An uninterrupted internet connection is a requirement for this role.

Physician Recruiter

• Lead and manage the day-to-day operations of the disability claims team.
• Supervise daily operations including case assignments and performance management.
• Oversee scheduling, quality assurance, and administrative functions; ensure all intakes are addressed promptly.
• Train, mentor, and develop team members to achieve individual and team goals.
• Drive client satisfaction by ensuring 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 for company policy and regulatory standards.
• Prepare reports on team performance and present findings to management.
• Perform other duties as assigned.

Disability Operations Supervisor

The Senior Accountant plays a crucial role in supporting the daily, monthly, and annual activities of the finance department. The Sr. Accountant should possess analytical & problem solving skills, be detail oriented, have solid conceptual thinking, and must be able to apply these traits to large datasets.
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.

• Program Leadership & Strategy:
• Lead the overall operations of Dane Street's Independent Dispute Resolution (IDR) program, ensuring compliance with federal regulations and guidelines.
• Contribute to the strategic direction of the IDR program, identifying opportunities for growth and efficiency.
• Stay informed of any changes to the IDR program and regulatory landscape, including updates from CMS, HHS, and DOJ.
• Operational Management & Workflow:
• Oversee the end-to-end workflow of IDR cases, from government portal intake to final determination.
• Optimize processes for case review, including the utilization of arbitrators and coders, to ensure timely and accurate determinations.
• Manage the integration and use of AccessDS for case tracking and management.
• Collaborate with the legal team to ensure all processes adhere to legal requirements and to address any contractual hurdles.
• Team Management & Development:
• Lead and manage a team of arbitrators, coders, and CSRs, including recruitment, training, and performance evaluation.
• Ensure arbitrators are credentialed and trained according to program requirements and internal standards.
• Oversee ongoing quality assurance for all reviews, reducing clarification needs and speeding up turnaround times.
• Financial & Administrative Oversight:
• Collaborate with the finance team to manage billing and revenue processes, focusing on upfront fees and payment collection from non-paying parties.
• Oversee the relationship with the escrow partner to ensure seamless handling of funds during the IDR process.
• Manage the budget for the IDR program, validating estimated numbers and timeframes.
• Stakeholder Communication & Relationship Management:
• Maintain effective communication with the Tri-Departments (CMS, HHS, DOJ) and other relevant entities.
• Address challenges related to incomplete information from initiating and non-initiating parties.
• Represent Dane Street in relevant industry discussions and conferences, such as NAIRO meetings.

Claims Quality Analyst

Occupational Therapy, Independent Medical Examiner

Board-Certified Neuropsychologist, Workers' Compensation IME

Senior Accountant

IME Quality Analyst, Liability

Customer Service Administrator

Customer Service Representative – Disability

Pain Management Physician, Physician Advisory Reviewer

Quality Assurance Specialist, Clinical RN – Disability

Group Health Operations Manager, RN/LPN

Physician Recruiter

Disability Operations Supervisor

Senior Accountant

VP of Operations, Independent Dispute Resolution