Calling all bill review professionals, CPC coders, AAPC, and DRG coders! Dane Street is looking for highly motivated Coders, bill reviewers, and payment integrity reviewers candidates to join our team. Dane Street offers an exciting work environment, competitive compensation, and strong growth potential.
Job Summary:
A new program offering on the group health side of our business enables you to apply your clinical knowledge to review reports accompanying medical records to ensure that medical billing information and coding are correct. You will communicate with other reviewers and their office teams to ensure clarity of information and ensure all questions posed have been addressed, and ensure that reports are returned within client deadlines.
Core Duties & Responsibilities:
Evaluates the appropriateness of codes and determine whether they meet all established program standards.Ensures that the medical records are matched appropriately to the codes and if not, obtains them.Read & apply policy guidelines and healthcare terminology and delineate when criteria are/are not met.Evaluates claims for conflict of interest and criteria appropriateness.Works within established timeframes set by program parameters.Provides strong customer service skills and works closely with clients on a case- by-case basis to provide complete, timely, and error-free quality assurance of cases.Provides clinical oversight to cases that are complex and need additional review prior to return to the client.Serves as an additional level of QA and clinical knowledge/review for cases with quality Issues.Requirements
Required Education & Experience:
● Must have a CPC, APCC, CMBS, or DRG coder certification
● Payment integrity or professional bill review experience is strongly preferred.
● Out-of-network bill review experience is a plus.
● Experience working in a remote environment is preferred.
● Experience in a medical office or health care background.
Required Skills:
● 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.
PLEASE BE AWARE: In the interest of the security of both parties, please be aware that
Dane Street will never conduct an interview via text or request checks from candidates
for purchasing equipment.
Benefits
Robust opportunity for supplemental incomeSchedule flexibility and predictable work hours-conduct reviews based on your schedule availabilityFully prepped cases, streamlined case flow, transcription services at no cost, and a user-friendly work portalA fast-paced, Inc. 500 Company with a high-performance culture, Dane Street is seeking
insightful, astute forward-thinking professionals. We process over 200,000 insurance
claims annually for leading national and regional Workers’ Compensation, Disability,
Auto and Group Health Carriers, Third-Party Administrators, Managed Care
Organizations, Employers and Pharmacy Benefit Managers. We provide customized
Independent Medical Exam and Peer Review programs that assist our clients in
reaching the appropriate medical determination as part of the claims management
process.
Read LessDane Street is expanding our physician panel! We are seeking a skilled and board-certified Toxicologist to join our team for Independent Medical Record Reviews. This is a fully remote opportunity offering flexible scheduling, allowing you to accept or decline cases based on your availability. Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case basis.
Dane Street is a national leader in Independent Medical Examinations, medical record reviews, and peer review services, trusted by insurance carriers and organizations nationwide for objective, high-quality medical evaluations.
Key Responsibilities:Thorough review and analysis of prepared medical recordsRequirements
Board certification in (Specialty) requiredBenefits
Robust opportunity for supplemental incomeIf you are a dedicated Toxicologist seeking a flexible, remote opportunity to apply your clinical expertise in an independent medical record review capacity, we encourage you to apply.
Read LessCalling all bill review professionals, CPC coders, AAPC, and DRG coders! Dane Street is looking for highly motivated Coders, bill reviewers, and payment integrity reviewers candidates to join our team. Dane Street offers an exciting work environment, competitive compensation, and strong growth potential.
Job Summary:
A new program offering on the group health side of our business enables you to apply your clinical knowledge to review reports accompanying medical records to ensure that medical billing information and coding are correct. You will communicate with other reviewers and their office teams to ensure clarity of information and ensure all questions posed have been addressed, and ensure that reports are returned within client deadlines.
Core Duties & Responsibilities:
Evaluates the appropriateness of codes and determine whether they meet all established program standards.Ensures that the medical records are matched appropriately to the codes and if not, obtains them.Read & apply policy guidelines and healthcare terminology and delineate when criteria are/are not met.Evaluates claims for conflict of interest and criteria appropriateness.Works within established timeframes set by program parameters.Provides strong customer service skills and works closely with clients on a case- by-case basis to provide complete, timely, and error-free quality assurance of cases.Provides clinical oversight to cases that are complex and need additional review prior to return to the client.Serves as an additional level of QA and clinical knowledge/review for cases with quality Issues.Requirements
Required Education & Experience:
● Must have a CPC, APCC, CMBS, or DRG coder certification
● Payment integrity or professional bill review experience is strongly preferred.
● Out-of-network bill review experience is a plus.
● Experience working in a remote environment is preferred.
● Experience in a medical office or health care background.
Required Skills:
● 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.
PLEASE BE AWARE: In the interest of the security of both parties, please be aware that
Dane Street will never conduct an interview via text or request checks from candidates
for purchasing equipment.
Benefits
Robust opportunity for supplemental incomeSchedule flexibility and predictable work hours-conduct reviews based on your schedule availabilityFully prepped cases, streamlined case flow, transcription services at no cost, and a user-friendly work portalA fast-paced, Inc. 500 Company with a high-performance culture, Dane Street is seeking
insightful, astute forward-thinking professionals. We process over 200,000 insurance
claims annually for leading national and regional Workers’ Compensation, Disability,
Auto and Group Health Carriers, Third-Party Administrators, Managed Care
Organizations, Employers and Pharmacy Benefit Managers. We provide customized
Independent Medical Exam and Peer Review programs that assist our clients in
reaching the appropriate medical determination as part of the claims management
process.
Read LessDane Street is expanding our physician panel! This is an in person opportunity for supplemental income 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. The ideal candidates will hold a TN license and be Board Certified in Oncology.
Requirements
As Physician Reviewer/Advisor, you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an 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.
MAJOR DUTIES AND RESPONSIBILITIES:
Reviews all medical records and addresses each question posed by the client utilizing client specific criteria or other nationally recognized evidence-based criteriaEnsures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decisionIdentifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizesProvides copies of any criteria utilized in a review with the report in a timely mannerReturns cases on or before the due date and timeMakes telephone calls as mandated by the state and/or client specificsMaintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the jobAttends all required orientation and trainingPerforms other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or auditsBoard certification required, active practice requiredPLEASE BE AWARE: In the interest of the security of all parties, Dane Street will never conduct interviews via text or request checks from candidates for any reason including the purchase of equipment.
Benefits
Robust opportunity for supplemental income
Schedule flexibility and predictable work hours - You choose services and case types, dictate volume, and conduct exams and reviews based on your schedule availabilityNo doctor/patient relationship is established and no treatment is provided. These are advisory-only opinions.Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management expertiseExpanded credentials as an expert in Independent Medical Exams and physician advisor servicesFully prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal
Dane Street supports all referral processes, scheduling, preps cases extensively, prepares all medical records, provides transcription services as applicable, facilitates all client communications, and ensures the quality and timeliness of all reports and report delivery.
Apply for this job
Read Less