Physician Reviewer for Independent Medical Exams

5 days ago

South Bend, Indiana, United States Dane Street Full time
Physician Reviewer Opportunity

At Dane Street, we are seeking a skilled Physician Reviewer to join our team of independent contract reviewers. As a Physician Reviewer, you will utilize your clinical expertise to review insurance appeals, prospective and retrospective claims, and provide interpretations of medical necessity.

Key Responsibilities:
  • Review medical records and address each question posed by the client using client-specific criteria or nationally recognized evidence-based guidelines
  • Ensure that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision
  • Identify, critique, and utilize current criteria and resources to support sound and objective decision-making and rationales in reviews
  • Provide copies of any criteria utilized in a review with the report in a timely manner
  • Return cases on or before the due date and time
  • Maintain proper credentialing and state licenses and any special certifications or requirements necessary to perform the job
  • Attend all required orientation and training
  • Perform other duties as assigned, including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits

Requirements:
  • Board certification required, active practice required
  • 5 years of experience in Vascular Surgery
  • OR Medical license

Benefits:
  • Robust opportunity for supplemental income
  • Schedule flexibility and predictable work hours
  • No doctor/patient relationship is established and no treatment is provided
  • Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management expertise
  • Expanded credentials as an expert in Independent Medical Exams and physician advisor services

Why Choose Dane Street?
  • Fully prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal
  • Dane Street supports all referral processes, scheduling, preps cases extensively, prepares all medical records, provides transcription services as applicable, facilitates all client communications, and ensures the quality and timeliness of all reports and report delivery

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