Disability Clinical RN – Quality Assurance Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Evaluate the quality of physician reports to ensure compliance with all client and jurisdictional standards related to long-term disability claims.

• Confirm that the claims align with the physicians' assessments in long-term disability cases.

• Review and interpret policy guidelines and healthcare terminology, identifying when long-term disability criteria are fulfilled.

• Deliver exceptional customer service by collaborating closely with clients on an individual case basis to ensure thorough, timely, and error-free quality assurance for long-term disability cases.

• Oversee and manage intricate long-term disability cases that require further examination before being returned to the client.

• Act as an additional quality assurance layer for cases with identified quality issues, applying clinical claims expertise specific to long-term disability.

• Engage in various other responsibilities and special projects as assigned based on business needs.

⛳️ Requirements

• An Associate’s Degree or Bachelor’s Degree is preferred.

• RN is mandatory.

• A minimum of 5 years of claims experience is preferred.

• Experience in disability claims is required.

• Business experience in a healthcare and/or insurance environment is preferred.

• Must possess a sense of urgency and the ability to meet deadlines.

• Self-motivated individuals with a strong commitment to performance excellence are essential.

• Exceptional written and verbal communication skills are required.

• Proficiency in using various computer programs (experience with Google Chrome, Gmail, Docs, Sheets, etc. is advantageous).

• Attention to detail is MANDATORY.

🏝️ Benefits

• Medical, dental, and vision coverage for you and your family.

• Voluntary life insurance options available for you, your spouse, and your children.

• Additional voluntary benefits including 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.