Orthopedics Physician ID- 10563
As Physician Reviewer/Advisor for Independent Medical Exams (IME), 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
Required
Preferred
Job Industries
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 criteria
- Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision
- Identifies, 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 sizes
- Provides copies of any criteria utilized in a review with the report in a timely manner
- Returns cases on or before the due date and time
- Makes telephone calls as mandated by the state and/or client specifics
- Maintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the job
- Attends all required orientation and training Remote Data Entry, $40/hr, Weekend Job, College Student Weekend Data Entry, $40/hr, Remote, No Experience Remote Live Chat, $40/hr, Part-Time, No Degree Required Remote Customer Support, $35/hr, Night Shift, No Degree Virtual Assistant, $40/hr, Remote, Weekend, Entry Level Remote Live Chat, $42/hr, Weekend, No Degree, Part-Time Remote Live Chat, $40/hr, Weekend, No Degree, Part-Time Virtual Assistant, No Experience, $40/hr, Remote, Part-Time Remote Moderator, $40/hr, College Student Friendly, Part-Time Virtual Assistant, Remote, $40/hr, Weekend, No Experience Remote Live Chat, $40/hr, College Student, No Experience Remote Live Chat, $42/hr, Weekend, No Degree, Part-Time Weekend Data Entry, $40/hr, Remote, No Experience Remote Moderator, $45/hr, No Degree, Weekend Job, Part-Time Entry-Level Remote Data Entry, $35/hr, Evening Job Customer Support, No Degree, $40/hr, Remote, Weekend Job Remote Phone Support, $45/hr, Night Job, College Student Virtual Assistant, $35/hr, Weekend, No Degree, Remote Virtual Assistant, $35/hr, Remote, Part-Time, Evening Job Virtual Assistant, Remote, $40/hr, Weekend, No Experience Phone Support, Remote, $35/hr, No Experience, Part-Time Phone Job, $35/hr, Remote, Part-Time, College Student Virtual Assistant, No Degree, $40/hr, Remote, Part-Time Weekend Data Entry, $45/hr, Remote, No Experience Phone Job, $40/hr, Remote, Night Shift, No Degree Data Entry, Remote, $42/hr, Evening Job, No Degree Remote Phone Job, $45/hr, Part-Time, No Degree Required Remote Phone Job, $40/hr, Night Shift, College Student Friendly Remote Phone Job, $42/hr, Night Shift, College Student Friendly Customer Support, $42/hr, Remote, Part-Time, No Degree Data Entry, No Experience, $35/hr, Remote, College Student Part-Time Customer Support, $40/hr, Remote, College Student Virtual Assistant, Remote, $40/hr, Evening, No Experience Phone Support, $40/hr, Remote, No Experience, Evening Job Remote Moderator, $40/hr, Weekend, No Experience Required Remote Live Chat, $50/hr, College Student, No Experience Phone Job, $35/hr, Remote, No Degree, Part-Time, Weekend Entry-Level Remote Data Entry, $50/hr, Evening Job Remote Moderator, $42/hr, Part-Time, Weekend, No Degree Remote Customer Support, $45/hr, Part-Time, College Student Phone Support, $35/hr, Weekend, Remote, No Experience Remote Phone Job, $42/hr, Night Shift, College Student Friendly Virtual Assistant, $40/hr, Weekend, College Student, Remote Phone Job, $50/hr, Remote, No Degree, Part-Time, Weekend Customer Support, $35/hr, Night Job, Remote, No Experience Remote Phone Job, $40/hr, Night Shift, College Student Friendly Live Chat Support, $40/hr, Weekend, Remote, No Degree Remote Moderator, $42/hr, Part-Time, Weekend, No Degree Data Entry, Remote, $40/hr, Night Shift, No Degree Phone Support, $45/hr, Remote, No Experience, Evening Job Remote Customer Support, $40/hr, No Degree, Evening Job Remote Data Entry, $42/hr, Evening/Night Job, No Experience Virtual Assistant, $42/hr, Remote, Weekend, Entry Level Virtual Assistant, $35/hr, Remote, Part-Time, Evening Job Remote Moderator, No Degree, $50/hr, Evening, Weekend Job Data Entry, No Degree, $40/hr, Part-Time, Remote Job Remote Customer Support, $40/hr, No Experience, Part-Time Virtual Assistant, $40/hr, Evening, Remote, College Student Virtual Assistant, No Degree, $45/hr, Remote, Part-Time Remote Phone Job, $45/hr, No Degree, College Student Friendly Remote Virtual Assistant, $40/hr, Evening, Part-Time Job Remote Live Chat, $42/hr, Weekend, No Degree, Part-Time Virtual Assistant, Remote, $35/hr, Part-Time, Night Shift Remote Live Chat, $40/hr, College Student, No Experience Data Entry, $50/hr, Remote, Evening Job, College Student Phone Job, $50/hr, Remote, Part-Time, College Student Remote Moderator, $40/hr, Weekend, No Degree, Part-Time Phone Job, $35/hr, Remote, Part-Time, College Student Remote Live Chat, $42/hr, Weekend, No Degree, Part-Time Live Chat Support, $45/hr, Part-Time, Remote, No Degree Remote Moderator, $45/hr, No Degree, Weekend Job, Part-Time Live Chat Support, $35/hr, Remote, No Experience Required Remote Data Entry, $50/hr, No Experience, Evening/Night Job Remote Data Entry, $40/hr, No Degree, Night Shift Customer Support, $40/hr, Remote, Part-Time, No Degree Data Entry, $35/hr, Remote, Evening Job, College Student Remote Moderator, $40/hr, Weekend, No Experience Required Remote Moderator, $42/hr, College Student, Weekend Job Remote Phone Support, $40/hr, Night Job, College Student Virtual Assistant, $40/hr, Evening, Remote, College Student Virtual Assistant, $40/hr, Remote, No Experience, Night Job Phone Job, $35/hr, Remote, Part-Time, College Student Virtual Assistant, No Experience, $42/hr, Remote, Part-Time Remote Customer Support, $40/hr, Night Job, No Experience Customer Support, $42/hr, Remote, Evening, No Experience Remote Data Entry, $40/hr, College Student Friendly, Part-Time Part-Time Data Entry, $45/hr, Remote, College Student Friendly Remote Phone Support, $45/hr, Evening, No Experience Required Remote Customer Support, $40/hr, Part-Time, College Student Remote Data Entry, $40/hr, Evening/Night Job, No Experience Data Entry, $45/hr, Remote, Evening, No Experience Required Remote Customer Support, $40/hr, Weekend, No Experience Remote Customer Support, $45/hr, Part-Time, College Student Remote Moderator, $42/hr, Weekend, No Experience Required Data Entry, $40/hr, Remote, Night Job, No Degree Virtual Assistant, Remote, $42/hr, Weekend, No Experience Remote Moderator, $42/hr, College Student, Weekend Job Remote Phone Job, $42/hr, Part-Time, College Student Friendly Virtual Assistant, Remote, $42/hr, Weekend, No Experience Data Entry, $45/hr, Remote, Night Shift, College Student Job Phone Support, $35/hr, Weekend, Remote, No Experience Live Chat Support, $35/hr, Remote, No Experience Required Remote Live Chat, $45/hr, College Student, No Experience Remote Data Entry, $40/hr, Part-Time, No Degree Required Live Chat Support, $45/hr, Part-Time, Remote, No Degree Remote Customer Support, $40/hr, Part-Time, College Student Evening Virtual Assistant, Remote, $45/hr, No Experience Virtual Assistant, No Degree, $45/hr, Remote, Part-Time Virtual Assistant, $40/hr, No Experience, Remote, Night Job Data Entry, $40/hr, Remote, Night Shift, College Student Job Customer Support, $42/hr, Remote, Part-Time, No Degree Virtual Assistant, $50/hr, Part-Time, Remote, Weekend Job Remote Live Chat, $35/hr, College Student, No Experience Phone Support, Remote, $35/hr, No Experience, Part-Time Remote Customer Support, $45/hr, No Experience, Part-Time Virtual Assistant, $40/hr, Remote, No Degree, Night Job Customer Support, $40/hr, Remote, Evening, No Experience Virtual Assistant, $50/hr, Weekend, No Degree, Remote Remote Data Entry, $35/hr, No Experience, Evening/Night Job Virtual Assistant, $50/hr, Remote, Part-Time, Evening Job Remote Phone Job, $40/hr, No Degree, College Student Friendly Remote Phone Support, $45/hr, Evening, No Experience Required Data Entry, $40/hr, Part-Time, Remote, Weekend Job Remote Live Chat, $50/hr, Part-Time, Evening/Night Job
- Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits
- Board certification required, active practice required
Required
Preferred
Job Industries
- Customer Service