Medical Review Specialist

2 weeks ago


Chicago, Illinois, United States Dane Street, LLC Full time

Dane Street, LLC, recognized as a certified "Great Place to Work," is actively seeking Board Certified Internal Medicine physicians to engage in Independent Medical Exams (IME) and Peer Reviews. This role offers the flexibility to tailor your schedule and caseload within a conventional Monday to Friday workweek while adhering to client-mandated turnaround times.

Physician Specialties: Internal Medicine

Physicians are required to be located in the following areas: Alsip/South Chicago Area

POSITION OVERVIEW:

Utilizing your clinical expertise, you will evaluate disability claims by interpreting the medical appropriateness of services rendered by other healthcare professionals, ensuring compliance with state regulations, nationally recognized evidence-based guidelines, and client-specific policies.

KEY RESPONSIBILITIES:

  • Thoroughly review all medical documentation and address each inquiry posed by the client using state-mandated or other nationally recognized evidence-based criteria.
  • Ensure that the rationale for your determinations is clear, concise, and supported by adequate documentation to substantiate your decisions.
  • Return cases by the specified due date and time.
  • Maintain proper credentialing, state licenses, and any special certifications or requirements necessary for the role.
  • Participate in all required orientation and training sessions.
  • Perform additional duties as assigned, including identifying and addressing quality assurance issues, regulatory concerns, depositions, court appearances, or audits.
  • Critically assess and utilize current criteria and resources, such as national, state, and professional association guidelines, to support objective decision-making in reviews; avoid relying on case studies or cohorts due to their limited sample sizes.
  • Provide copies of any criteria utilized in a review along with the report in a timely manner.
  • Conduct Independent Medical Exams in a professional, safe, and clean environment.

IMPORTANT NOTICE: For the security of both parties, please note that Dane Street will never conduct interviews via text or request checks from candidates for purchasing equipment.


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