Dane Street
Cardiology - Independent Medical Examiner (IME)
Dane Street, Naples, Florida, United States, 33939
Cardiology - Independent Medical Examiner (IME)
As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise to review insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client-specific policies, nationally recognized evidence-based guidelines, and standards of care.
Responsibilities
Reviews all medical records and addresses each question posed by the client using client-specific criteria or other nationally recognized evidence-based criteria
Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision
Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making; refrains from using case studies or cohorts with limited sample sizes
Provides copies of any criteria utilized in a review with the report in a timely manner
Returns cases on or before the due date and time
Makes telephone calls as mandated by the state and/or client specifics
Maintains proper credentialing, state licenses, and any special certifications or requirements necessary to perform the job
Attends required orientation and training
Performs other duties as assigned, including identifying and responding to quality assurance issues, regulatory issues, depositions, court appearances, or audits
Board certification required; active practice required
PLEASE BE AWARE: In the interest of security, Dane Street will never conduct interviews via text or request checks from candidates for any reason, including the purchase of equipment.
Benefits
Robust opportunity for supplemental income
Schedule flexibility and predictable work hours — you choose services and case types, dictate volume, and conduct exams and reviews based on your schedule availability
No doctor-patient relationship is established and no treatment is provided. These are advisory-only opinions
Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management expertise
Expanded credentials as an expert in Independent Medical Exams and physician advisor services
Fully prepped cases, streamlined case flow, transcription services at no cost, and a user-friendly work portal
Dane Street supports all referral processes, scheduling, case preparation, medical records preparation, transcription services as applicable, facilitates all client communications, and ensures the quality and timeliness of all reports and report delivery.
Seniority level
Entry level
Employment type
Full-time
Job function
Other
Industries
IT Services and IT Consulting
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Responsibilities
Reviews all medical records and addresses each question posed by the client using client-specific criteria or other nationally recognized evidence-based criteria
Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision
Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making; refrains from using case studies or cohorts with limited sample sizes
Provides copies of any criteria utilized in a review with the report in a timely manner
Returns cases on or before the due date and time
Makes telephone calls as mandated by the state and/or client specifics
Maintains proper credentialing, state licenses, and any special certifications or requirements necessary to perform the job
Attends required orientation and training
Performs other duties as assigned, including identifying and responding to quality assurance issues, regulatory issues, depositions, court appearances, or audits
Board certification required; active practice required
PLEASE BE AWARE: In the interest of security, Dane Street will never conduct interviews via text or request checks from candidates for any reason, including the purchase of equipment.
Benefits
Robust opportunity for supplemental income
Schedule flexibility and predictable work hours — you choose services and case types, dictate volume, and conduct exams and reviews based on your schedule availability
No doctor-patient relationship is established and no treatment is provided. These are advisory-only opinions
Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management expertise
Expanded credentials as an expert in Independent Medical Exams and physician advisor services
Fully prepped cases, streamlined case flow, transcription services at no cost, and a user-friendly work portal
Dane Street supports all referral processes, scheduling, case preparation, medical records preparation, transcription services as applicable, facilitates all client communications, and ensures the quality and timeliness of all reports and report delivery.
Seniority level
Entry level
Employment type
Full-time
Job function
Other
Industries
IT Services and IT Consulting
#J-18808-Ljbffr