Spine Surgeon Telecommute Medical Review Specialist
4 weeks ago
We are seeking a skilled Spine Surgeon to join our medical review team in a telecommute role. As a Board Certified Spine Surgeon or Board Certified Neurosurgeon, you will review health claims and provide medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals.
Responsibilities- Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and Medical Leave Act (FMLA), Group health and workers' compensation claims.
- Meets with Concentra Physician Review Medical Director to discuss quality of care and credentialing and state licensure issues.
- Maintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the job.
- Returns cases in a timely manner with clear concise and complete rationales and documented criteria.
- Telephonically contacts providers and interacts with other health professionals in a professional manner.
- Board certified MD, DO, with an excellent understanding of network services and managed care, appropriate utilization of services and credentialing, quality assurance and the development of policies that support these services.
- Current, unrestricted clinical license(s) (or if the license is restricted, the organization has a process to ensure job functions do not violate the restrictions imposed by the State Board).
- Board certification by American Board of Medical specialties or American Board of Osteopathic Specialties is required for MD or DO reviewer.
- Phone accessibility.
- Access to a computer to complete reviews.
- Ability to complete cases accompanied by a typed report in specified time frames.
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New York, New York, United States Concentra Full timeJob SummaryWe are seeking a skilled Orthopedic Surgeon to join our Telecommute Medical Review team. As a key member of our team, you will be responsible for reviewing medical files and providing recommendations for utilization review, chart reviews, and medical necessity.ResponsibilitiesReview medical files and provide recommendations for utilization review,...
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Telecommute Medical Review Specialist
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Telecommute Medical Review Specialist
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New York, New York, United States Concentra Full timeJob Summary:Concentra is seeking a skilled Board Certified Neurosurgeon to join our medical review team as a telecommute medical review specialist. As a medical review specialist, you will be responsible for reviewing health claims and providing medical interpretation and decisions about the appropriateness of services provided by other healthcare...
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New York, New York, United States Concentra Full timeJob Title: Telecommute Medical Review PhysicianJob Summary:Concentra is seeking a Telecommute Medical Review Physician to join our team. As a Telecommute Medical Review Physician, you will review medical files and provide recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term...
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Telecommute Medical Review Physician
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New York, New York, United States Concentra Full timeJob Summary:Concentra is seeking a skilled Telecommute Medical Review Physician to join our team. As a Telecommute Medical Review Physician, you will review medical files and provide recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and Medical Leave...
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Telecommute Medical Review Stream Physician
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New York, New York, United States Concentra Full timeJob Summary:Relying on clinical background, reviews health claims providing medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with Concentra Physician Review policies, procedures, and performance standards and URAAC guidelines and state regulations.This telecommute role...
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Telecommute Medical Review Stream Physician
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New York, New York, United States Concentra Full timeJob SummaryConcentra is seeking a Telecommute Medical Review Stream Physician to join our team. As a Telecommute Medical Review Stream Physician, you will be responsible for reviewing medical files and providing recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term...
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New York, New York, United States Medicorp Inc Full timeUnlock Your Potential as a Leading Orthopedic Spine SurgeonAt Medicorp Inc, we're committed to delivering exceptional patient care and fostering a culture of innovation and collaboration. As a leading orthopedic spine surgeon, you'll have the opportunity to work with a multidisciplinary team of experts in a state-of-the-art facility.Key...
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New York, New York, United States Concentra Full timeJob Summary:Relying on clinical background, reviews health claims providing medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with Concentra Physician Review policies, procedures, and performance standards and URAAC guidelines and state regulations.Responsibilities:Reviews...
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New York, New York, United States Concentra Full timeJob SummaryRelying on clinical background, reviews health claims providing medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with Concentra Physician Review policies, procedures, and performance standards and URAAC guidelines and state regulations.ResponsibilitiesReviews...
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New York, New York, United States Concentra Full timeJob Summary:Relying on clinical background, reviews health claims providing medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with Concentra Physician Review policies, procedures, and performance standards and URAAC guidelines and state regulations.Responsibilities:Reviews...
