New Mexico-Licensed Physician Reviewers (M.D., D.O.)-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, ensuring compliance with guidelines and standards of care.

In Short

• Telework opportunity with customizable schedule
• Compensation on a per-case basis as a 1099 independent contractor
• Active NM License required
• 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
• Perform other assigned duties

Requirements

• Active NM License
• Clinical expertise in relevant specialties
• Ability to review and interpret medical necessity
• Knowledge of evidence-based guidelines
• Strong communication skills
• Attention to detail
• Ability to meet deadlines
• Experience in healthcare reviews
• Familiarity with regulatory issues
• Ability to work independently

Benefits

• Flexible work schedule
• Work from home
• Independent contractor status
• Opportunity to work in various specialties
• Potential for professional growth