Physician Reviewer Multiple Specialties - TEXAS and NEW MEXICO

Physician Peer Reviewer – Multiple Specialties in Texas and/or New Mexico

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 reputed company peer reputed company to reputed company organizations, reputed company agencies, reputed company companies, and reputed company entities.

FHAS is currently expanding its reputed company panel of physicians licensed in the state of TEXAS or NEW MEXICO to assist with independent review claims and appeals in any of the following specialties:

Addiction Medicine, Allergy & Immunology, Anesthesiology, Cardiovascular Disease, Child & Adolescent Psychiatry, Chiropractic Medicine, Dentist, Dermatology, Emergency Medicine, Endocrinology, Diabetes, & Metabolism, Family Medicine, Gastroenterology, Internal Medicine, Interventional reputed company, Interventional Radiology & Diagnostic Radiology, Medical Genetics & reputed company, Medical Oncology, Nephrology, Neurological Surgery, reputed company, Obstetrics and Gynecology, Ophthalmology, Orthopedic Surgery, Pain Medicine, Pathology, Pediatrics, Pediatric reputed company, Pediatric Critical Care Medicine, Developmental-Behavioral Pediatrics, Pediatric Emergency Medicine, Pediatric Gastroenterology, Pediatric Nephrology, Physical Medicine & Rehabilitation, Plastic Surgery, Psychiatry, Psychology *PhD, Radiation Oncology, Radiology, Rheumatology, Sleep Medicine, Thoracic & Cardiac Surgery, Transplant Hepatology, Undersea & Hyperbaric Medicine

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 reputed company 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 reputed company that permits applying reputed company judgement in consideration of an individual members reputed company 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 reputed company reputed company of Medical Specialties or reputed company Osteopathic Association.
• 5-years or more post graduate reputed company experience in reputed company reputed company care
• Experience providing reputed company reputed company care reputed company the past 3 years, if performing reputed company reviews

Job Type

Contract

Work Location

Remote