Board Certified-(M.D, D.O) Pittsburg, KS Oncology Advisor-Certified for IME

As a Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize your clinical expertise to review insurance appeals, as well as prospective and retrospective claims. The Physician Reviewer will interpret the medical necessity of services provided by healthcare professionals, ensuring compliance with client-specific policies, nationally recognized evidence-based guidelines, and standards of care. MAJOR DUTIES AND RESPONSIBILITIES: Review all medical records and address each question posed by the client using client-specific criteria or other nationally recognized evidence-based criteria. Ensure that the rationale for the determination is clear, concise, and supported by adequate documentation to substantiate the decision. Identify, critique, and utilize current criteria and resources such as national, state, and professional association guidelines, peer-reviewed literature, supporting sound and objective decision-making. Avoid reliance on case studies or cohorts due to limited sample sizes. Provide copies of any criteria used in a review along with the report in a timely manner. Return cases on or before the due date and time. Make telephone calls as mandated by state and/or client specifics. Maintain proper credentialing, state licenses, and any required certifications. Attend all required orientation and training sessions. Perform additional duties as assigned, including addressing quality assurance issues, complaints, regulatory matters, depositions, court appearances, or audits. Board certification and active practice are 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 equipment purchases. Benefits Robust opportunity for supplemental income Flexible schedule with predictable work hours—choose services and case types, dictate volume, and conduct exams and reviews based on your availability No doctor/patient relationship is established; these are advisory-only opinions Enhance your industry expertise in medical necessity and utilization review/management Expand credentials as an expert in IMEs and physician advisory services Fully prepped cases, streamlined case flow, transcription services at no cost, and a user-friendly work portal

#J-18808-Ljbffr