Physician Reviewer: Orthopedic Surgery - Spine Surgeon - 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 other duties as assigned related to quality assurance and regulatory issues.

Requirements

• Preferred candidates will hold a TX license.
• Ability to work independently as a contractor.
• Strong understanding of healthcare policies and guidelines.
• Excellent communication skills for client interactions.
• Attention to detail in documentation and reporting.

Benefits

• Flexible scheduling and caseload management.
• Work from home opportunity.
• Compensation on a per-case basis.