A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful forward-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers’ Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We provide customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.
Board Certified Internal Medicine Physician Reviewer
Location
United States
Posted
6 days ago
Salary
Not specified
Seniority
Mid Level
No structured requirement data.
Job Description
Role Description
Dane Street is expanding our physician panel! This is a telework opportunity for supplemental income for physicians providing a caseload customized to your schedule. Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case basis.
As a Physician Reviewer/Advisor for Disability Peer Review, you will utilize clinical expertise to review medical records provided and return an independent, professional opinion on the claimant’s functionality and restrictions or limitations as it relates to an application for disability benefits or the current status of disability. Determinations are based on the clinical evidence within the medical records provided.
- On a contract basis, as individual schedule permits, accepts cases, reviews all medical records, and addresses each question posed utilizing client-specific criteria or other nationally recognized evidence-based criteria, and opines on disability status.
- Ensures a clear rationale for the determination that is concise and contains adequate supporting documentation to substantiate the decision.
- Identifies and employs current criteria and resources, such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to make decisions.
- Provides a report and copies of any criteria utilized within the review promptly.
- Returns cases on or before the due date and time specified.
- Completes peer-to-peer calls/call attempts as required based on client-specific protocol with the goal of obtaining information not included in medical records as well as any necessary clarification.
- Performs other duties as assigned, including addressing any necessary clarification, providing addendum as required (with additional compensation), identifying and responding to potential quality assurance issues, complaints, and regulatory issues.
Qualifications
- US Board certification required, active practice preferred.
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, preps cases extensively, prepares all medical records, provides transcription services as applicable, facilitates all client communications, and ensures the quality and timeliness of all reports and report delivery.
Job Requirements
- US Board certification required, active practice preferred.
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, preps cases extensively, prepares all medical records, provides transcription services as applicable, facilitates all client communications, and ensures the quality and timeliness of all reports and report delivery.
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