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Healthcare Consultant
1 week ago
We're looking for a highly skilled Healthcare Consultant to join our team at Dane Street, LLC. As a consultant, you will utilize your clinical expertise to review insurance appeals and claims, ensuring that they meet client-specific policies and nationally recognized evidence-based guidelines.
Main Responsibilities:
- Reviews medical records and addresses each question posed by the client using client-specific criteria or nationally recognized evidence-based guidelines.
- Ensures that the rationale for the determination is clear, concise, and supported by adequate documentation.
- Utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature to inform decision-making.
- Provides copies of criteria used in reviews with the report in a timely manner.
Requirements:
- Holds a WA license and is certified, or willing to become certified, with the Washington State Department of Labor and Industries (L&I).
- Conducts in-person exams in Bellevue, WA, with potential for additional locations in the future.
- Dane Street covers reasonable travel expenses.
- Assists with obtaining WA L&I certification.