Physician Advisory Services Clinical QA Specialist

Summary

Join our team at Dane Street and enjoy a comprehensive benefits package designed to support your well-being and peace of mind.

Requirements

• An Active Registered Nurse License
• A Bachelor’s Degree is preferred
• Business experience in a healthcare and/or insurance setting is preferred

Responsibilities

• 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
• 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 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
• Provides clinical oversight to cases that are complex and need additional review prior to return to client
• Serves as an additional level of QA for cases with Quality Issues
• 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

Benefits

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