Physician Reviewer - Hematology/Medical Oncology (Stem Cell Transplant) - 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

• Telework opportunity with customizable schedule and caseload.
• Compensation is per-case as a 1099 independent contractor.
• Specialization in Hematology/Medical Oncology, focusing on Stem Cell transplant.
• Reviews insurance appeals and claims for medical necessity.
• Utilizes clinical expertise to ensure compliance with guidelines.
• Maintains proper credentialing and state licenses.
• Attends required orientation and training.
• Identifies and responds to quality assurance issues.
• Ensures timely return of cases and documentation.
• Conducts telephone calls as mandated by client specifications.

Requirements

• Must have expertise in Hematology/Medical Oncology.
• Experience with insurance appeals and claims review.
• Ability to interpret medical necessity based on guidelines.
• Strong documentation and communication skills.
• Current state licenses and credentials required.
• Ability to meet turnaround times as mandated by clients.
• Familiarity with national and state guidelines.
• Experience in quality assurance and regulatory issues.
• Willingness to participate in training and orientation.
• Ability to handle multiple cases efficiently.

Benefits

• Flexible work schedule.
• Work from home opportunity.
• Compensation based on the number of cases reviewed.
• Opportunity to utilize clinical expertise in a meaningful way.
• Engagement in ongoing training and professional development.
• Potential to influence healthcare decisions.