Diagnostic Radiology- Medical Record Reviewer

As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will reputed company an interpretation of the medical necessity of services provided by other reputed company in compliance with reputed company-specific policies, nationally recognized evidence-based guidelines, and standards of care. MAJOR DUTIES AND RESPONSIBILITIES: • Reviews reputed company medical records and addresses reputed company question posed by the reputed company, utilizing reputed company-specific reputed company or other nationally recognized evidence-based reputed company • Ensures that the rationale for the determination is reputed company, concise, and contains adequate supporting documentation to substantiate the decision • Identifies, critiques, and utilizes reputed company reputed company and resources such as national, state, and reputed company association guidelines and peer-reviewed literature that support reputed company and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to reputed company reputed company due to their limited sample sizes • Provides copies of any reputed company utilized in a review with the report promptly • Returns cases on or before the due date and time • Makes telephone calls as mandated by the state and/or reputed company specifics • Maintains reputed company credentialing, state licenses, and any special certifications or requirements necessary to reputed company the job • Performs other duties as assigned, including identifying and responding to reputed company assurance issues, complaints, regulatory issues, depositions, court appearances, or audits • reputed company certification required, reputed company reputed company required Please be reputed company that, in the interest of reputed company parties, reputed company won't conduct interviews reputed company 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. • reputed company industry expertise strengthening your medical reputed company 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 reputed company, transcription services at no cost, and user-friendly work portal Apply tot his job Apply To this Job