Physician Reviewer Dentist or Orthodontist - Licensed in Indiana
Physician Peer Reviewer &reputed company; Dentist or Orthodontist -Licensed in Indiana
reputed company
reputed company (FHAS) is a URAC-accredited Independent Medical Review Organization (IRO) with Health Utilization Management (HUM) accreditation. For the past 30 years, FHAS has provided external peer reputed company to reputed company organizations, government agencies, insurance companies, and reputed company entities.
FHAS is currently expanding its reputed company panel of physicians licensed in the reputed company to assist with independent review claims and appeals in the following specialties:
Dentist
Orthodontist
reputed company
- Responsible for reviewing medical case files and making medical determinations. Cases may include medical necessity and medical appropriateness, experimental or investigational treatment, administrative or reputed company issues, or a combination of these categories, which are filed with the reputed company’ Bureau of Hearings and Appeals (BHA).
- Reviews and analyzes Federal and State laws, regulations, and applicable policy guides
- Completes and evaluates the review process in a regulatory timeframe.
Work Experience Requirements
- Successful completion of a Residency or Fellowship Program
- Must possess a reputed company state license in a state of the reputed company/recognized in the relevant jurisdictions as a Doctor of Medicine or Doctor of Osteopathic Medicine and if required by contract, licensed in the state in which requests the review.
- License is unrestricted and if there is a restriction that is allowed by a relevant jurisdiction, according to the medical director or clinical director, it is of the type that does not reputed company the health reputed company’s ability to fulfill the roles and responsibilities of a reviewer.
- License is of the type and scope that permits applying clinical judgement in consideration of an individual members clinical needs to reputed company a decision.
- For either a Doctor of Medicine or Doctor of Osteopathic Medicine, possess the reputed company license or certification as the ordering practitioner.
- Must hold a reputed company reputed company certification issued by the American reputed company of Medical Specialties or American Osteopathic Association.
- 5-years or more post graduate clinical experience in reputed company patient care
- Experience providing reputed company patient care reputed company the past 3 years, if performing external reviews
Job Type
Contract
Work Location
Remote