Board Certified Physician Reviewer - Organ Transplant - 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
• 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 complaints
• Perform other assigned duties as needed
• Conduct telephone calls as mandated

Requirements

• Clinical expertise in organ transplant
• Experience with insurance appeals and claims
• Ability to interpret medical necessity
• Knowledge of evidence-based guidelines
• Proper credentialing and state licenses
• Strong communication skills
• Attention to detail
• Ability to meet deadlines
• Willingness to attend training
• Ability to handle quality assurance issues

Benefits

• Flexible work schedule
• Work from home
• Independent contractor status
• Opportunity to work with a variety of cases
• Potential for professional growth