As a physician reviewer/advisor for independent medical exams (ime), you will utilize clinical expertise to review insurance appeals and claims, providing an interpretation of the medical necessity of services in compliance with client-specific policies, evidence-based guidelines, and standards of care. major duties and responsibilities: 1. review all medical records and address each question posed by the client using specific criteria or recognized evidence-based standards. 2. ensure that the rationale for decisions is clear, concise, and supported with adequate documentation. 3. utilize current criteria and resources such as national, state, and professional guidelines, and peer-reviewed literature to support objective decision-making, avoiding limited sample studies. 4. provide copies of utilized criteria with the review report promptly. 5. complete reviews on or before the due date. 6. make mandated telephone calls as required by state or client specifications. 7. maintain proper credentials, licenses, and certifications necessary for the role. 8. attend all required orientation and training sessions. 9. perform additional duties including addressing quality assurance, regulatory issues, and participating in audits or court appearances. board certification and active practice are required. additional information: - benefits include supplemental income, flexible scheduling, and no doctor-patient relationship. - enhance your industry expertise and credentials in ime and physician advisory services. - case preparation, transcription, and client communication are suppo...
As a physician reviewer/advisor for independent medical exams (ime), you will utilize clinical expertise to review insurance appeals and claims, providing an interpretation of the medical necessity of services in compliance with client-specific policies, evidence-based guidelines, and standards of care. major duties and responsibilities: 1. review all medical records and address each question posed by the client using specific criteria or recognized evidence-based standards. 2. ensure that the rationale for decisions is clear, concise, and supported with adequate documentation. 3. utilize current criteria and resources such as national, state, and professional guidelines, and peer-reviewed literature to support objective decision-making, avoiding limited sample studies. 4. provide copies of utilized criteria with the review report promptly. 5. complete reviews on or before the due date. 6. make mandated telephone calls as required by state or client specifications. 7. maintain proper credentials, licenses, and certifications necessary for the role. 8. attend all required orientation and training sessions. 9. perform additional duties including addressing quality assurance, regulatory issues, and participating in audits or court appearances. board certification and active practice are required. additional information: - benefits include supplemental income, flexible scheduling, and no doctor-patient relationship. - enhance your industry expertise and credentials in ime and physician advisory services. - case preparation, transcription, and client communication are suppo...
As a physician reviewer/advisor for independent medical exams (ime), you will utilize clinical expertise to review insurance appeals and claims, providing an interpretation of the medical necessity of services in compliance with client-specific policies, evidence-based guidelines, and standards of care. major duties and responsibilities: review all medical records and address each question posed by the client using specific criteria or recognized evidence-based standards. ensure that the rationale for decisions is clear, concise, and supported with adequate documentation. utilize current criteria and resources such as national, state, and professional guidelines, and peer-reviewed literature to support objective decision-making, avoiding limited sample studies. provide copies of utilized criteria with the review report promptly. complete reviews on or before the due date. make mandated telephone calls as required by state or client specifications. maintain proper credentials, licenses, and certifications necessary for the role. attend all required orientation and training sessions. perform additional duties including addressing quality assurance, regulatory issues, and participating in audits or court appearances. board certification and active practice are required. additional information: benefits include supplemental income, flexible scheduling, and no doctor-patient relationship. enhance your industry expertise and credentials in ime and physician advisory services. case preparation, transcription, and client communication are supported by the company to streamline work...
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