Board Certified -Texas Licensed Physicians (M.D, D.O.) - Multiple Specialties - Remote

Overview

This telework opportunity allows you 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.

In Short

• Candidates must hold an active Texas license.
• Utilizes clinical expertise to review insurance appeals and claims.
• Provides interpretation of medical necessity of services.
• Reviews medical records and addresses client questions.
• Ensures clear rationale for determinations with supporting documentation.
• Identifies and utilizes current criteria and resources for decision-making.
• Maintains proper credentialing and state licenses.
• Attends required orientation and training.
• Performs other duties as assigned, including quality assurance issues.
• Telecommute position with flexible scheduling.

Requirements

• Active Texas medical license.
• Experience in reviewing medical records and insurance claims.
• Knowledge of nationally recognized evidence-based guidelines.
• Ability to provide clear and concise documentation.
• Strong communication skills for client interactions.
• Ability to meet deadlines and manage caseload effectively.
• Familiarity with healthcare regulations and standards.
• Commitment to ongoing training and credentialing.
• Experience in specific physician specialties is a plus.
• Independent contractor status with per-case compensation.

Benefits

• Flexible scheduling and caseload management.
• Work from home opportunity.
• Compensation on a per-case basis.
• Opportunity to utilize clinical expertise in a meaningful way.
• Engagement with various healthcare professionals.
• Potential for professional development and training.
• Supportive work environment.
• Access to resources for decision-making.
• Independence in managing work responsibilities.
• Contribution to quality assurance in healthcare.