Physician Reviewer: Orthopedic Surgery
2 weeks ago
This telework opportunity provides the ability to customize your schedule and caseload within the week while maintaining client-mandated turnaround times. Our reviewers are compensated on a per-case basis as a 1099 independent contractor.
Job Summary
Preferred candidates will hold a TX license.
Utilizes clinical expertise, and reviews insurance appeals, prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client specific policies, nationally recognized evidence-based guidelines, and standards of care.
MAJOR DUTIES AND RESPONSIBILITIES:
- Reviews all medical records and addresses each question posed by the client utilizing client specific criteria or other nationally recognized evidence-based criteria
- Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision
- Identifies, critiques, and utilizes 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; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes
- Provides copies of any criteria utilized in a review with the report in a timely manner
- Returns cases on or before the due date and time
- Makes telephone calls as mandated by the state and/or client specifics
- Maintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the job
- Attends all required orientation and training
- Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits
-
Physician - Orthopaedic Surgeon
1 month ago
West Palm Beach, United States Center for Orthopedic and Research Excel Full timeJob DescriptionJob DescriptionCenter for Bone & Joint Surgery is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the musculoskeletal system. All our facilities feature highly trained orthopedic surgeons, each with a specific area of expertise.Our physicians are sub-specialty trained in sports medicine,...
-
Physician Reviewer: Orthopedic Surgery
4 weeks ago
West Palm Beach, United States Dane Street, LLC Full timeJob DescriptionJob DescriptionThis telework opportunity provides the ability to customize your schedule and caseload within the week while maintaining client-mandated turnaround times. Our reviewers are compensated on a per-case basis as a 1099 independent contractor.Preferred candidates will hold a TX license.JOB SUMMARYUtilizes clinical expertise, and...
-
Orthopedic Surgeon
4 weeks ago
Daytona Beach, United States THE ORTHOPEDIC CLINIC Full timeJob DescriptionJob DescriptionDescription:The Orthopedic Clinic is seeking a Board Certified Fellowship Orthopedic Trauma Surgeon to join our growing practice. The Orthopedic Clinic is a well-respected practice that was established in 1961 and has a rich history of providing exceptional Orthopedic care to the community. We currently have twelve Orthopedic...
-
Orthopedic Surgeon
2 weeks ago
Daytona Beach, United States The Orthopedic Clinic Full timeJob Type Full-timeDescriptionThe Orthopedic Clinic is seeking a Board Certified Fellowship Orthopedic Trauma Surgeon to join our growing practice. The Orthopedic Clinic is a well-respected practice that was established in 1961 and has a rich history of providing exceptional Orthopedic care to the community. We currently have twelve Orthopedic Surgeons,...
-
Surgery Authorization Representative
5 days ago
Virginia Beach, United States Aligned Orthopedic Partners Full timeWho we are: Aligned Orthopedic Partners is a well-respected private orthopedic team comprised of highly trained, board-certified orthopedic surgeons devoted to delivering patients with the highest orthopedic care possible. Our commitment to finding the best solutions for individual needs sets us apart from the competition. We take pride in providing...
-
Surgery Authorization Representative
2 weeks ago
Virginia Beach, United States Aligned Orthopedic Partners Full timeWho we are: Aligned Orthopedic Partners is a well-respected private orthopedic team comprised of highly trained, board-certified orthopedic surgeons devoted to delivering patients with the highest orthopedic care possible. Our commitment to finding the best solutions for individual needs sets us apart from the competition. We take pride in providing...
-
Surgery Authorization Representative
4 days ago
Virginia Beach, United States Aligned Orthopedic Partners Full timeWho we are: Aligned Orthopedic Partners is a well-respected private orthopedic team comprised of highly trained, board-certified orthopedic surgeons devoted to delivering patients with the highest orthopedic care possible. Our commitment to finding the best solutions for individual needs sets us apart from the competition. We take pride in providing...
-
Physician Reviewer: Neurological Surgery
1 month ago
West Palm Beach, United States Dane Street, LLC Full timeJob DescriptionJob DescriptionThis telework opportunity provides the ability to customize your schedule and caseload within the week while maintaining client-mandated turnaround times. Our reviewers are compensated on a per-case basis as a 1099 independent contractor.Preferred candidates will hold a NY License, and be NY WC Board Certified.JOB...
-
Surgery Authorization Representative
4 weeks ago
Virginia Beach, United States Aligned Orthopedic Partners Full timeJob DescriptionJob DescriptionDescription:Who we are:Aligned Orthopedic Partners is a well-respected private orthopedic team comprised of highly trained, board-certified orthopedic surgeons devoted to delivering patients with the highest orthopedic care possible. Our commitment to finding the best solutions for individual needs sets us apart from the...
-
West Palm Beach, Florida, United States Envision Physician Services Full timeLooking for an outstanding opportunity with a LUCRATIVE COMPENSATION PACKAGE AND NO CALL? Envision Physician Services is currently seeking a qualified CRNA for a full-time opportunity at Northpoint Surgery and Laser Center in West Palm Beach, FL. Northpoint Surgery and Laser Center is a multi-specialty surgery center with 5 Operating rooms, 2 Endoscopy...
-
Orthopedic Surgeon
1 month ago
Daytona Beach, United States THE ORTHOPEDIC CLINIC Full timeJob DescriptionJob DescriptionDescription: The Orthopedic Clinic is seeking a Board Certified Fellowship Hand & Upper Extremity Orthopedic Surgeon to join our growing practice. The Orthopedic Clinic is a well-respected practice that was established in 1961 and has a rich history of providing exceptional Orthopedic care to the community. We currently have...
-
Orthopedic Surgeon
2 weeks ago
Daytona Beach, United States The Orthopedic Clinic Full timeJob Type Full-timeDescriptionThe Orthopedic Clinic is seeking a Board Certified Fellowship Hand & Upper Extremity Orthopedic Surgeon to join our growing practice. The Orthopedic Clinic is a well-respected practice that was established in 1961 and has a rich history of providing exceptional Orthopedic care to the community. We currently have nine Orthopedic...
-
Surgery Coordinator
2 weeks ago
Newport Beach, United States Newport Orthopedic Institute Full timeThe Surgery Coordinator is responsible for all aspects of surgery process including, but not limited to: insurance verification, pre-operative certifications/authorizations, scheduling patients for any pre-operative labs, testing and coordination of post-surgery care. ESSENTIAL DUTIES & RESPONSIBILITIES:Coordinate surgical schedules for orthopedic...
-
Surgery Coordinator
2 weeks ago
Newport Beach, United States Newport Orthopedic Institute Full timeThe Surgery Coordinator is responsible for all aspects of surgery process including, but not limited to: insurance verification, pre-operative certifications/authorizations, scheduling patients for any pre-operative labs, testing and coordination of post-surgery care. ESSENTIAL DUTIES & RESPONSIBILITIES:Coordinate surgical schedules for orthopedic...
-
Front Office Representative
1 month ago
West Palm Beach, United States Center for Orthopedic and Research Excel Full timeJob DescriptionJob DescriptionCenter for Bone & Joint Surgery is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the body's musculoskeletal system. Our locations feature a staff of highly trained orthopedic surgeons, each with a specific area of expertise.Center for Bone & Joint Surgery offers a team...
-
Orthopedic Surgery
1 week ago
West Liberty, United States Medicorp Inc Full timeOpportunity Overview Seeking an Orthopedic physician to join our dynamic medical team at Medical Center in WV. Your medical expertise will make a meaningful impact on the well-being of our diverse patient community. Come be the best at the best! Job Details* An average practice schedule is 2 days in clinic and 3 days in surgery Average daily clinic patient...
-
Orthopedic Surgery
4 days ago
West Liberty, United States Medicorp Inc Full timeOpportunity Overview Seeking an Orthopedic physician to join our dynamic medical team at Medical Center in WV. Your medical expertise will make a meaningful impact on the well-being of our diverse patient community. Come be the best at the best! Job Details* An average practice schedule is 2 days in clinic and 3 days in surgery Average daily clinic patient...
-
Orthopedic Surgery job in: Key West, FL
4 days ago
Key West, United States Archway Physician Recruitment LLC Full timeOrthopedic Surgery opening in Key West, FLFull-Time & PermanentSeeking a BE/BC Orthopedic Surgeon to join practice.- Employed position - Joining established single specialty group - Single office location- Competitive salary - Commencement bonus - Assistance with medical education debt - CME expenses - Relocation assistanceLocation:- A locale rich in history...
-
Orthopedic Surgery West Branch, MI
1 week ago
West Branch, United States MyMichigan Health Full timeRequirementsMyMichigan Health, an affiliate the University of Michigan, has an outstanding opportunity for an Orthopedic Surgeon in West Branch, MI. The MD/DO must be board certified or board eligible by the American Board of Orthopedic Surgery or the American Osteopathic Board of Orthopedic Surgery or the equivalent board in another country which is...
-
Orthopedic Surgery Position
3 weeks ago
West Branch, Michigan, United States MyMichigan Health Full timeSummary: MyMichigan Health, an affiliate the University of Michigan, has an outstanding opportunity for an Orthopedic Surgeon in West Branch, MI. The MD/DO must be board certified or board eligible by the American Board of Orthopedic Surgery or the American Osteopathic Board of Orthopedic Surgery or the equivalent board in another country which is recognized...