Telecommute Medical Review Physician

1 week ago


Washington, Washington, D.C., United States Concentra Career Choice Full time
Overview

We are seeking experienced physicians to join our medical review team as telecommute reviewers. As a telecommute reviewer, you will have the flexibility to create your own schedule and work on a per-case basis as an independent contractor.

Responsibilities
  • Review medical files and provide recommendations for utilization review, chart reviews, medical necessity, and appropriateness of care.
  • Meet with our medical director to discuss quality of care and credentialing issues.
  • Maintain proper credentialing and state licenses, as well as any special certifications or requirements necessary to perform the job.
  • Return cases in a timely manner with clear and concise rationales and documented criteria.
  • Interact with healthcare professionals in a professional manner and discuss disclaimers and appeal processes with providers.
  • Perform other duties as assigned, including identifying and responding to quality assurance issues, complaints, and regulatory issues.
Qualifications
  • Board certified MD or DO with an excellent understanding of network services and managed care.
  • Current, unrestricted clinical license(s) and board certification by American Board of Medical specialties or American Board of Osteopathic Specialties.
  • Post-graduate experience in direct patient care and demonstrated computer skills, telephonic skills, and ability to work with various professionals.
Working Conditions

This role requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.

Concentra is an Equal Opportunity Employer and is committed to protecting patient data and ensuring the privacy of personal and medical information.



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