Board Certified Physician Reviewer (MD/DO) - Pediatrics (Multiple Specialties) - Remote

Overview

This telework opportunity allows you to customize your schedule and caseload while maintaining client-mandated turnaround times. The physician reviewer will utilize clinical expertise to review insurance appeals and claims.

In Short

• Telework opportunity with customizable schedule
• Compensation on a per-case basis as a 1099 independent contractor
• Must be Board Certified in Pediatrics or a related subspecialty
• Review medical records and address client questions
• Ensure clear and concise rationale for determinations
• Utilize current criteria and resources for decision-making
• Maintain proper credentialing and state licenses
• Attend required orientation and training
• Respond to quality assurance issues and audits
• Make mandated telephone calls

Requirements

• Board Certification in Pediatrics or relevant subspecialty
• Clinical expertise in reviewing medical necessity
• Ability to interpret medical records and guidelines
• Strong communication skills for client interactions
• Attention to detail in documentation and reporting
• Ability to meet deadlines and turnaround times
• Maintaining state licenses and certifications
• Experience in quality assurance processes
• Willingness to participate in training
• Ability to handle regulatory issues and audits

Benefits

• Flexible work schedule
• Work from home
• Independent contractor status
• Opportunity to utilize clinical expertise
• Engagement with a variety of cases
• Potential for professional development
• Networking opportunities within the healthcare field
• Access to resources and guidelines for decision-making
• Supportive work environment
• Contribution to quality assurance in healthcare