Expert Hematology Oncology Physician Reviewer
6 days ago
We are seeking an experienced Hematology/Oncology Physician to join our team as a telehealth reviewer. As a contractor with Dane Street, you will have the flexibility to customize your schedule and caseload while maintaining client-mandated turnaround times.
This opportunity offers a flat rate for Group Health Record/Policy Reviews and allows you to work on a per-case basis. Our reviewers are compensated as 1099 independent contractors.
To be eligible, candidates must hold an active Texas License and have expertise in Physician Specialties: Hematology/Medical Oncology.
About the Role:- You will utilize clinical expertise to review insurance appeals and prospective and retrospective claims.
- Your interpretation of medical necessity will be guided by client-specific policies, nationally recognized evidence-based guidelines, and standards of care.
The average length of time to review each case is between 15-30 minutes. Cases are prepared in advance for your review, and some may require a short turnaround time.
Responsibilities:- Review all medical records and address each question posed by the client using 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.
- Maintain proper credentialing and state licenses and any special certifications or requirements necessary to perform the job.
- Attend all required orientation and training.
- Perform other duties as assigned, including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits.
Please note that Dane Street prioritizes security and will never conduct an interview via text or request checks from candidates for purchasing equipment.
This telehealth opportunity offers a competitive salary of $150,000 - $200,000 annually, depending on experience and location.
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