Job description

The Customer Service Representative is responsible for receipt of new cases and ensuring proper system drafting and setup. The CSR also is responsible for taking direction and facilitating the case assignment/scheduling process.

MAJOR DUTIES & RESPONSIBILITIES

Handling Receipt of New Cases:

Intake new cases and review/verify information and requests. Draft cases by entering information into the Dane Street system, AccessDS.
Work with the client on any information missing pertinent to processing the claim.
Sort, organize and create a medical document listing - if required by the client, and in line with specific special handling.

Oversight of Cases:

Monitor, process and track cases to ensure we meet deadlines.

Assignment of Cases:

Assign/schedule new cases to physicians for review with the appropriate physician, based on location, reviewer availability, specific guidelines, jurisdictional requirements and other client requirements.
Ensure that the assigned physician has no conflict of interest with the case assignments

Client Interaction:

Update clients frequently on cases in progress.
May communicate when there are questions on referral information to ensure proper documentation and information is provided to the assigned reviewer.
Ensure proper documentation for specified cases is provided to the client.

Requirements

COMMUNICATION: Indicate applicable type of communication

✓ External

✓ Internal

EDUCATION/CREDENTIALS:

An Associate’s Degree preferred.

JOB RELEVANT EXPERIENCE:

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

JOB RELATED SKILLS/COMPETENCIES:

Good communication skills with a clear understanding of company business lines. The ability to apply

critical thinking, manage time efficiently 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.

Benefits

Join our team at Dane Street and enjoy a comprehensive benefits package designed to support your well-being and peace of mind. We offer a range of benefits including medical, dental, and vision 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 recharge, while our 401k plan with a company match helps you plan for your future. Apple equipment and a media stipend are provided for remote workspace.

ABOUT DANE STREET:

A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful 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 Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.

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