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Disability Claims QA
Dane StreetDisability Claims QA ensuring quality and accuracy of long-term disability claims and physician reports. Collaborating with clients to maintain clarity and meet deadlines in managing cases.
About the role
Key responsibilities & impact- 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, determining when criteria for long-term disability are met
- 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
Requirements
What you’ll need- An Associate’s Degree or Bachelor’s Degree is preferred
- 5+ years of claims experience, preferred
- Disability experience required
- Business experience in a healthcare and/or insurance setting is preferred
- Must work with a sense of urgency and meet deadlines
- Must be self-motivated, with a strong drive for performance excellence
- Excellent written and verbal communication skills are required
- Proficiency in navigating a variety of computer programs (Experience with Google Chrome, Gmail, Docs, Sheets, etc. is a plus)
- Attention to detail REQUIRED
- 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
Benefits
Comp & perks- 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 for remote workspace
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims experiencedisability experiencequality assurancehealthcare terminologypolicy guidelinescritical thinkingattention to detailtime management
Soft Skills
customer serviceself-motivatedperformance excellencewritten communicationverbal communicationurgencyorganizational skills
Certifications
Associate’s DegreeBachelor’s Degree