Independent Medical Examiner (IME) - Orthopedic Surgery - Remote

Overview

As a Physician Reviewer/Advisor for Independent Medical Record Reviews, you will leverage your clinical expertise to review insurance appeals and evaluate prospective and retrospective claims.

In Short

• Review medical records and address client questions using specific criteria.
• Provide clear, concise rationale for determinations supported by documentation.
• Utilize current guidelines and literature for objective decision-making.
• Complete and return cases by assigned deadlines.
• Make telephone calls to clients as required.
• Maintain proper credentialing and certifications.
• Respond to quality assurance issues and regulatory inquiries.
• Board certification and active practice required.

Requirements

• Medical degree and board certification.
• Experience in insurance appeals and medical necessity evaluations.
• Strong clinical expertise in orthopedic surgery.
• Ability to work independently and manage time effectively.
• Excellent communication skills.

Benefits

• Opportunity for supplemental income.
• Flexible schedule based on case volume.
• Remote work with no doctor/patient relationship.
• Enhanced expertise in medical necessity and utilization review.
• Fully prepped cases and transcription services provided.