Telecommute Medical Review Specialist

20 hours ago


Washington, Washington, D.C., United States Concentra Career Choice Full time
Overview:

Are you a skilled and experienced Board Certified Psychiatrist looking for a flexible work arrangement? We are seeking a talented professional to join our medical review team as a Telecommute Medical Review Specialist.

This role provides the opportunity to work from home and customize your schedule within a Monday - Friday work week and within business hours. As a 1099 independent contractor, you will be compensated on a per case basis.

Candidates must have a CO license and a Level 1 or Level 2 Accreditation.

Responsibilities:
  • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and Medical Leave Act (FMLA), Group health and workers compensation claims.
  • Meets with Concentra Physician Review Medical Director to discuss quality of care and credentialing and state licensure issues.
  • Maintain proper credentialing and state licenses and any special certifications or requirements necessary to perform the job.
  • Returns cases in a timely manner with clear concise and complete rationales and documented criteria.
  • Telephonically contacts providers and interacts with other health professionals in a professional manner.
Qualifications:
  • Current, unrestricted clinical license(s) (or if the license is restricted, the organization has a process to ensure job functions do not violate the restrictions imposed by the State Board);
  • Board certification by American Board of Medical specialties or American Board of Osteopathic Specialties is required for MD or DO reviewer.
  • Must be in active medical practice to perform appeals.
Working Conditions/Physical Demands:
  • Phone accessability
  • Access to a computer to complete reviews
  • Ability to complete cases accompanied by a typed report in specified time frames
  • Telephonic conferences


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