Anesthesiologist with Pain Management Telecommute Medical Review

Concentra; Clifton (NJ); Remote; USD 150,000 - 220,000; Full time

Job summary

An established industry player is seeking a Board Certified Anesthesiologist for a telecommute role in medical review. This position allows for a flexible schedule, enabling you to balance your work and life effectively while providing essential medical interpretations and decisions on health claims. You'll be part of a dynamic team, ensuring compliance with policies and guidelines, all while enjoying the autonomy of an independent contractor role. If you are passionate about patient care and have a strong clinical background, this opportunity is perfect for you.

Qualifications

• Board certified MD or DO with understanding of network services and managed care.
• Current, unrestricted clinical license(s) required.

Responsibilities

• Review medical files and recommend regarding utilization review and medical necessity.
• Communicate professionally with providers and health professionals.

Skills

Computer Skills

Telephonic Skills

Negotiation Skills

Communication Skills

Ability to Perform Reviews Effectively

Education

Board Certified MD or DO

Job description

Anesthesiologist with Pain Management Telecommute Medical Review

Join to apply for the Anesthesiologist with Pain Management Telecommute Medical Review role at Concentra.

Overview

Are you an accomplished Board Certified Anesthesiologist? Candidates must have a NJ license. Are you passionate about your work/life balance? We are seeking flexible and experienced physicians for our medical review division. This telecommute role allows you to customize your schedule and caseload within a Monday - Friday work week during business hours. Create a flexible work schedule and be compensated on a per case basis as a 1099 independent contractor.

Job Summary

Relying on your clinical background, review health claims by providing medical interpretation and decisions regarding the appropriateness of services rendered by other healthcare professionals, in compliance with Concentra Physician Review policies, procedures, and standards, as well as URAAC guidelines and state regulations.

Responsibilities

• Review medical files and recommend regarding utilization review, chart reviews, medical necessity, appropriateness of care, return to work, disability claims, FMLA, and insurance claims.
• Meet with Concentra Physician Review Medical Director as required to discuss quality of care and credentialing issues.
• Maintain proper credentialing, licenses, and certifications.
• Return cases promptly with clear, concise, and complete rationales.
• Communicate professionally with providers and other health professionals, discussing disclaimers and appeal processes.
• Attend orientation and training sessions.
• Perform additional duties including responding to QA issues, regulatory compliance, and audits.
• Utilize current guidelines and literature to support decision-making.
• Provide criteria used in reviews upon request.

Qualifications

• Board certified MD or DO with understanding of network services, managed care, and credentialing.
• Current, unrestricted clinical license(s).
• Active medical practice experience, especially for appeals.

Skills and Competencies

• Computer and telephonic skills.
• Ability to perform reviews effectively.
• Professional interaction with various healthcare and regulatory professionals.
• Evidence of liability coverage.
• Knowledge of current practice standards and managed care orientation.
• Strong negotiation and communication skills.

Working Conditions

• Access to a computer and phone.
• Ability to complete cases within specified timeframes.

This role involves handling confidential information, requiring discretion and secure data management.

Additional Information

This position is an independent contractor role. Concentra is an Equal Opportunity Employer and is committed to data protection and privacy policies.