Physician Reviewer

3 months ago

Bellevue, United States Dane Street Full time

This opportunity provides the ability to customize your schedule and caseload within the week while maintaining client-mandated turnaround times. Our reviewers are compensated on a per-case basis as a 1099 independent contractor.

Preferred candidates will hold a WA license and be certified, or willing to become certified, with the Washington State Department of Labor and Industries (L&I).

Highlights:

  • In-person Exams to be conducted in Bellevue, WA, with additional locations to be added in the future
  • Multiple exams over the course of a day
  • Dane Street will pay for reasonable travel expenses
  • Dane Street will assist you in obtaining WA L&I certification
  • Video recording of approximately 15% of exams may be needed

JOB SUMMARY

Utilizes 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 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
  • Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits

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.

  • Physician Reviewer

    2 days ago

    Bellevue, Washington, United States Dane Street, LLC Full time

    Job SummaryDane Street, LLC is seeking a highly skilled Physician Reviewer to join our team. As a Physician Reviewer, you will utilize your clinical expertise to review insurance appeals, prospective and retrospective claims, and provide an interpretation of the medical necessity of services provided by other healthcare professionals.Key...

  • Physician Reviewer

    3 months ago

    Bellevue, United States Dane Street, LLC Full time

    This opportunity provides the ability to customize your schedule and caseload within the week while maintaining client-mandated turnaround times. Our reviewers are compensated on a per-case basis as a 1099 independent contractor.Preferred candidates will hold a WA license and be certified, or willing to become certified, with the Washington State Department...

  • Independent Medical Exams and Physician Reviewer Positions

    2 days ago

    Bellevue, Washington, United States Dane Street, LLC Full time

    About the RoleDane Street, LLC is seeking experienced physicians to join our team as Independent Medical Exams (IME) reviewers and advisors. As a physician reviewer/advisor, you will play a critical role in supporting our organization's mission to provide high-quality, independent medical evaluations.Key ResponsibilitiesReview medical records and conduct...

  • Physician Reviewer

    3 months ago

    Bellevue, United States Dane Street, LLC Full time

    Job DescriptionJob DescriptionThis opportunity provides the ability to customize your schedule and caseload within the week while maintaining client-mandated turnaround times. Our reviewers are compensated on a per-case basis as a 1099 independent contractor.Preferred candidates will hold a WA license and be certified, or willing to become certified, with...

  • Utilization Review Nurse

    3 days ago

    Bellevue, Washington, United States Overlake Medical Center Full time

    Job SummaryWe are seeking a highly skilled Utilization Review Nurse to join our team at Overlake Medical Center. As a Utilization Review Nurse, you will play a critical role in ensuring that patients receive the right care at the right time, while also driving adherence to regulatory and payer guidelines.Key ResponsibilitiesConduct preadmission, admission,...

  • Utilization Review Nurse

    2 weeks ago

    Bellevue, United States Overlake Medical Center & Clinics Part time

    Welcome to a medical center where you're the center of attention.Pay Range$50.78 - $76.17Utilization Review Nurses collaborate with the care team across the continuum to assure high quality, safe and cost effective patient care. Utilization Review Nurses drive adherence to regulatory and payer guidelines and work in partnership with Social Workers to assure...

  • Anesthesiology Physician

    2 weeks ago

    Bellevue, United States RecruitWell Full time

    DocCafe has an immediate opening for the following position: Anesthesiology Physician in Bellevue, Ohio. DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career. Register now to apply for this job and for access to 125,000+ other openings. DocCafe Offers: Free Physician and Advanced Practice Job Search...

  • Anesthesiology Physician

    5 days ago

    bellevue, United States RecruitWell Full time

    DocCafe has an immediate opening for the following position: Anesthesiology Physician in Bellevue, Ohio. DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career. Register now to apply for this job and for access to 125,000+ other openings. DocCafe Offers: Free Physician and Advanced Practice Job Search...

  • Anesthesiology Physician

    5 hours ago

    Bellevue, United States Cross Country Locums Full time

    DocCafe has an immediate opening for the following position: Anesthesiology Physician in Bellevue, Ohio. DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career. Register now to apply for this job and for access to 125,000+ other openings. DocCafe Offers: Free Physician and Advanced Practice Job Search...

  • Surgery - General Physician

    2 days ago

    bellevue, United States NOW Healthcare Recruiting (NP Now) Full time

    DocCafe has an immediate opening for the following position: Surgery-General Physician in Bellevue, Washington. DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career. Register now to apply for this job and for access to 125,000+ other openings. DocCafe Offers: Free Physician and Advanced Practice Job...

  • Primary Care Physician

    3 months ago

    Bellevue, United States Department Of Veterans Affairs Full time

    Summary This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment....

  • Anesthesiology Physician

    3 months ago

    Bellevue, United States DocCafe Full time

    DocCafe has an immediate opening for the following position: Physician - Anesthesiology in Bellevue, Ohio.DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career.----------------Register now to apply for this job and for access to 120,000+ other openings.DocCafe Offers:Free Physician and Advanced Practice...

  • Family Practice/Primary Care Physician Assistant

    2 weeks ago

    Bellevue, United States Vituity Full time

    DocCafe has an immediate opening for the following position: Family Practice/Primary Care Physician Assistant in Bellevue, Washington. DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career. Register now to apply for this job and for access to 125,000+ other openings. DocCafe Offers: Free Physician and...

  • Family Practice/Primary Care Physician Assistant

    3 hours ago

    Bellevue, United States Vituity Full time

    DocCafe has an immediate opening for the following position: Family Practice/Primary Care Physician Assistant in Bellevue, Washington. DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career. Register now to apply for this job and for access to 125,000+ other openings. DocCafe Offers: Free Physician and...

  • Board Certified

    4 weeks ago

    Bellevue, United States Dane Street, LLC Full time

    Job DescriptionJob DescriptionDane Street is expanding our physician panel! Dane Street is an Independent Review Organization and a national provider of Independent Medical Exams (IMEs), among other offerings, and we are expanding our physician panel resulting in opportunities for non-traditional physician work and supplemental income. We have a need to add...

  • Board Certified

    3 months ago

    Bellevue, United States Dane Street, LLC Full time

    Job DescriptionJob DescriptionDane Street is expanding our physician panel! Dane Street is an Independent Review Organization and a national provider of Independent Medical Exams (IMEs), among other offerings, and we are expanding our physician panel resulting in opportunities for non-traditional physician work and supplemental income. We have a need to add...

  • Family Practice-Without OB Physician

    2 months ago

    Bellevue, United States DocCafe Full time

    DocCafe has an immediate opening for the following position: Physician - Family Practice-Without OB in Bellevue, Washington.DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career.----------------Register now to apply for this job and for access to 120,000+ other openings.DocCafe Offers:Free Physician and...

  • Physician Leader

    6 days ago

    Bellevue, Washington, United States OrangeTwist Full time

    Job SummaryWe are seeking a skilled Supervising Physician to join our dynamic leadership team at OrangeTwist. As a Physician with OrangeTwist, you will be responsible for overseeing a range of non-surgical cosmetic treatments and medical aesthetics services that our team of providers (RN, NP, PA, LE) provide to our patients.Key ResponsibilitiesOversee...

  • Nurse Practitioner or Physician Assistant

    4 weeks ago

    Bellevue, United States MRG Exams Full time

    Work can be performed by a Nurse Practitioner or Physician Assistant We are looking for the right Nurse Practitioner or Physician Assistant to perform medical assessments on United States Veterans as part of the VA's disability benefits process.In performing Disability Assessments, you will review medical records electronically through a web portal and...

  • Nurse Practitioner or Physician Assistant

    2 days ago

    Bellevue, United States MRG Exams Full time

    Work can be performed by a Nurse Practitioner or Physician Assistant We are looking for the right Nurse Practitioner or Physician Assistant to perform medical assessments on United States Veterans as part of the VA's disability benefits process.In performing Disability Assessments, you will review medical records electronically through a web portal and...