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Physician Reviewer: Neurological Surgery - Remote

Posted 58 weeks ago

Overview

This telework opportunity provides the ability 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

  • 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 for decision-making.
  • Maintains proper credentialing and state licenses.
  • Attends required orientation and training.
  • Performs duties related to quality assurance and regulatory issues.
  • Returns cases on or before the due date.
  • Makes telephone calls as mandated by state/client specifics.

Requirements

  • Must hold a NY License and be NY WC Board Certified.
  • Clinical expertise in reviewing medical necessity.
  • Ability to work independently as a contractor.
  • Strong understanding of evidence-based guidelines.
  • Excellent communication skills for client interactions.
  • Attention to detail in documentation and reporting.
  • Ability to meet deadlines and turnaround times.
  • Experience in healthcare or related field.
  • Familiarity with regulatory issues in healthcare.
  • Commitment to maintaining credentialing and licenses.

Benefits

  • Flexible schedule and caseload management.
  • Work from home opportunity.
  • Compensation on a per-case basis.
  • Independence as a 1099 contractor.
  • Opportunity to utilize clinical expertise.
  • Engagement with a variety of cases.
  • Access to professional development through training.
  • Supportive work environment.
  • Potential for long-term contract work.
  • Networking opportunities within the healthcare field.

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