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Medical Review Specialist
2 months ago
Dane Street, LLC, recognized as a certified "Great Place to Work," is seeking Board Certified Internal Medicine physicians to perform Independent Medical Exams (IME) and Peer Reviews. This role offers the flexibility to tailor your schedule and caseload within a standard Monday to Friday work week while adhering to client-mandated turnaround times.
Physician Specialties: Internal Medicine
Position Overview:
As a Medical Review Specialist, you will leverage your clinical expertise to evaluate disability claims, ensuring the medical appropriateness of services rendered by other healthcare professionals in accordance with state regulations, recognized evidence-based guidelines, and client-specific policies.
Key Responsibilities:
- Thoroughly review all medical documentation and address inquiries from clients using state-mandated or nationally recognized evidence-based criteria.
- Provide clear and concise rationales for determinations, supported by adequate documentation.
- Ensure timely return of cases, adhering to due dates.
- Maintain necessary credentials, state licenses, and any special certifications required for the role.
- Participate in all mandatory orientation and training sessions.
- Perform additional duties as assigned, including addressing quality assurance issues, regulatory concerns, and audits.
- Critically assess and utilize current criteria and resources, including national and state guidelines, to support objective decision-making.
- Deliver copies of any criteria used in reviews alongside reports in a timely manner.
- Conduct Independent Medical Exams in a professional and safe environment.
Important Note: For the security of both parties, please be advised that Dane Street will not conduct interviews via text or request checks from candidates for purchasing equipment.
