Physician Reviewer Specialist

18 hours ago


Bellevue, Washington, United States Dane Street Full time
Job Overview

We are seeking a skilled Physician Reviewer to join our team at Dane Street. As a key member of our staff, you will utilize your clinical expertise to review insurance appeals and claims, ensuring compliance with client-specific policies and nationally recognized guidelines.

Responsibilities
  • Review medical records and address each question posed by the client using client-specific criteria or nationally recognized evidence-based criteria.
  • Ensure that rationales for determinations are clear, concise, and contain adequate supporting documentation.
  • Critique current criteria and resources to support sound decision-making and provide copies of utilized criteria with reports.


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