Medical Review Specialist
2 weeks ago
This remote position allows for flexible scheduling and caseload management while adhering to client-required turnaround times. Reviewers are compensated on a per-case basis as independent contractors.
Candidates must be a licensed Orthopedic Surgeon in Texas with experience in testimony, depositions, or counter affidavits. Access to a Texas notary or availability for online notary services is also required.
POSITION SUMMARY
Our Medical Review Specialists should possess substantial expertise in evaluating the application of CPT codes alongside state fee schedule reductions across various jurisdictions, with a comprehensive understanding of CPT codes and the associated state-specific fees.
KEY RESPONSIBILITIES:
- Thoroughly reviews all medical documentation and addresses client inquiries using client-specific or nationally recognized evidence-based criteria.
- Ensures that the rationale for decisions is clear, concise, and supported by adequate documentation.
- Identifies and utilizes current guidelines and resources, including national, state, and professional association standards, as well as peer-reviewed literature, to support objective decision-making.
- Provides copies of any criteria used in reviews along with the report in a timely manner.
- Submits cases by the designated due date and time.
- Maintains necessary credentials, state licenses, and any special certifications required for the role (TX license is mandatory).
- Participates in all required orientation and training sessions.
- Performs additional duties as assigned, including addressing quality assurance issues, regulatory matters, depositions, court appearances, or audits.
IMPORTANT NOTICE: For the security of all parties, please note that Dane Street will not conduct interviews via text or request payment from candidates for equipment purchases.
Benefits Offered
We provide generous Paid Time Off, a comprehensive benefits package, and a competitive salary. Equipment and media stipends are available for remote workspaces. Our robust training program ensures a smooth onboarding process. If you seek a dynamic environment where you can make significant contributions, we welcome your interest.
ABOUT DANE STREET:
Dane Street, LLC is a rapidly growing, Inc. 500 Company with a high-performance culture, seeking insightful and forward-thinking professionals. We handle over 200,000 insurance claims annually for leading national and regional Workers' Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. Our customized Independent Medical Exam and Peer Review programs assist clients in achieving appropriate medical determinations as part of the claims management process.
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