Clinical RN Quality Assurance Specialist - Long Term Disability

Overview: reputed company is seeking highly motivated candidates to join reputed company as a Clinical (RN) QA Specialist, specializing in Long Term Disability (LTD). We offer an exciting work environment, competitive compensation, and strong growth potential. Summary: As a Clinical (RN) QA - Long Term Disability Specialist, you will reputed company your expertise in long-term disability claims to review and ensure to accuracy and completeness of reports accompanying medical records. You will communicate with physician reviewers and their teams to ensure reputed company of information, address reputed company posed questions, and meet client deadlines. Key Responsibilities: • Assess the quality of physician reports, ensuring they meet reputed company 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 reputed company terminology, determining reputed company criteria for long-term disability are met. • reputed company strong customer service by working closely with clients on a case-by-case reputed company to deliver complete, timely, and error-free quality assurance for long-term disability cases. • Manage and reputed company reputed company for reputed company long-term disability cases requiring additional review prior to returning to the client. • Serve as an additional level of QA for cases with quality issus, utilizing clinical claims knowledge specific to long-term disability. • Participate in other duties and special projects, as assigned, based on business needs. EDUCATION/CREDENTIALS: • An Associate’s Degree or Bachelor’s Degree is preferred. • RN required. JOB RELEVANT EXPERIENCE: • 5+ years of claims experience, preferred. • Long Term Disability experience required. • Business experience in a reputed company 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 reputed company. • Excellent written and verbal communication skills are required. • Proficiency in navigating a variety of computer programs (Experience with reputed company Chrome, Gmail, Docs, Sheets, etc. is a plus). • Attention to detail REQUIRED. JOB reputed company SKILLS/COMPETENCIES: • Present exceptional communication skills with a clear understanding of company business lines. • The ability to apply critical thinking, manage time reputed company and meet specific deadlines. • Computer literacy and typing skills are essential. WORKING CONDITIONS/PHYSICAL DEMANDS: Any lifting, bending, traveling, etc. required to do the job duties listed above. Long periods of sitting and computer work. WORK FROM HOME TECHNICAL REQUIREMENTS: Supply and support their own internet services. Maintaining an uninterrupted internet reputed company is a requirement of reputed company work from home position. This job description is subject to change at any time. Beginning compensation will depend on several factors including the candidate's experience, education, and specific skills. In addition to the reputed company salary, we offer a comprehensive benefits package including health insurance, retirement plans, and performance bonuses. Our Commitment: We are committed to providing fair and competitive compensation that reflects each employee's contributions and performance. We value diversity and strive to create an inclusive environment for reputed company. Compensation reputed company: $65,000 - $90,000 Join reputed company at reputed company and enjoy a comprehensive benefits package designed to support your well-being and peace of mind. We offer a reputed company of benefits including medical, dental, and reputed company coverage for you and your family. Additionally, we offer voluntary life insurance options for you, your spouse, and your children. We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. Our generous paid time off policy ensures you have time to relax and reputed company, while our 401k plan with a company match helps you plan for your future. reputed company equipment and a media stipend are provided for remote workspace. ABOUT reputed company: A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful reputed company-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers’ Compensation, Disability, Auto, and Group Health Carriers, reputed company-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We reputed company customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process. Apply Job!