New Mexico-Licensed Physician Reviewers (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 NM 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 and concise rationale for determinations.
• Identifies and utilizes current criteria and resources.
• Maintains proper credentialing and state licenses.
• Attends required orientation and training.
• Performs other duties as assigned.
• Returns cases on or before the due date.

Requirements

• Active NM License required.
• Experience in reviewing medical records.
• Knowledge of evidence-based guidelines.
• Ability to provide clear documentation.
• Strong communication skills for client interactions.
• Ability to meet deadlines.
• Familiarity with healthcare regulations.
• Attention to detail in decision-making.
• Ability to work independently.
• Commitment to quality assurance standards.

Benefits

• Flexible schedule and caseload.
• Work from home opportunity.
• Compensation on a per-case basis.
• Independence as a 1099 contractor.
• Opportunity to utilize clinical expertise.
• Engagement with various medical specialties.
• Access to ongoing training and orientation.
• Supportive work environment.
• Potential for professional growth.
• Networking opportunities within the healthcare field.