Physician Reviewer: Neurological Surgery - Remote

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.