Dane Street

• The Legal 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. • 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.

**JOB SUMMARY** The 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. ****

• Evaluate and review disability claims • Conduct work from the convenience of home • Enjoy flexible scheduling and balance work with lifestyle

• Reviewing medical records and supporting documentation • Conducting evidence-based clinical assessments • Preparing clear, comprehensive written reports • Participating in peer-to-peer discussions when necessary • Answering client-specific questions regarding occupational injuries, work-related illnesses, treatment plans, functional limitations, and return-to-work recommendations • Applying current clinical guidelines, evidence-based medicine, and occupational health standards to all reviews

• conduct thorough reviews of clinical cases • evaluate medical records • provide clinical summaries • engage in peer communications • answer specific questions posed by clients

• Evaluate medical records • Prepare concise clinical summaries • Provide independent medical opinions in response to specific client questions • Assess medical necessity, causation, work-relatedness, impairment, disability status, return-to-work recommendations, and appropriateness of treatment • Conduct evidence-based clinical assessments • Prepare clear, comprehensive written reports • Participate in peer-to-peer discussions when necessary • Answer client-specific questions regarding occupational injuries, illnesses, and workplace health concerns • Apply current clinical guidelines and standards of care to all reviews

• Evaluate and review disability claims from home • Work with a panel of independent physicians • Maintain flexibility in scheduling and workload

• The 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 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. • 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. • 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. ********

• Identify and vet specialty physicians (All specialties, including Orthopedic Surgeons, Neurologists, PM&R, etc.), ensuring full state coverage in California. • Maintain working knowledge of physician networks and recruitment processes. • Collaborate with healthcare and insurance organizations to streamline recruitment efforts. • Utilize computer platforms to analyze network gaps and optimize recruitment efficiency. • Manage relationships with high-level medical specialists for recruitment initiatives.

• Dane Street is an Independent Review Organization and a national provider of Utilization Review services (among other offerings) and we are expanding our physician panel resulting in opportunities for non-traditional physician work and supplemental income. • This is a telework opportunity for physicians providing a caseload customized to your schedule. • Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case basis. • We are looking for the specialties listed below with active **Tennessee License** to address the medical necessity of treatment requests and, in appeals, the medical necessity of previously denied services. • The average time spent on most reviews is 15-20 minutes so it is possible to complete several cases within an hour. • Training and onboarding can be completed in less than 1 week and you can start earning compensation for reviews while maintaining your active practice.