Physician Reviewer
6 days ago
We are seeking a highly skilled Physician Reviewer to join our team in Bellevue, WA.
About the RoleThis is a per-case basis opportunity for independent contractors. Our reviewers will utilize their clinical expertise to review insurance appeals, and prospective and retrospective claims.
The successful candidate 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.
Key Responsibilities- Review all medical records and address each question posed by the client utilizing client-specific criteria or other nationally recognized evidence-based criteria.
- 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 such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews.
The ideal candidate will have excellent analytical and communication skills, be able to work independently, and maintain proper credentialing and state licenses and any special certifications or requirements necessary to perform the job.
Compensation and BenefitsWe offer a competitive compensation package, including a salary range of $120,000 - $180,000 per year, depending on experience, plus benefits and opportunities for professional growth.
In addition, we will pay for reasonable travel expenses and assist you in obtaining WA L&I certification.
Work EnvironmentYou will be working from home, conducting in-person exams in Bellevue, WA, with additional locations to be added in the future.
Dane Street values its employees' well-being and provides a supportive work environment.
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