Board Certified - IME/RR Neurology - Panama City, FL

Dane Street, LLC; Panama City (FL); On-site; USD 80,000 - 150,000; Full time

Job summary

An established industry player is seeking skilled Physician Reviewers for Independent Medical Exams in Panama City. This telework opportunity offers flexible scheduling and the chance to enhance your expertise in medical necessity and utilization review. As a Physician Reviewer, you'll leverage your clinical knowledge to assess insurance appeals and claims, ensuring compliance with established guidelines. This role allows you to dictate your workload while providing valuable advisory opinions without establishing a doctor/patient relationship. Join a supportive team that streamlines your workflow and enhances your professional credentials in a dynamic and rewarding environment.

Benefits

Schedule Flexibility

Supplemental Income

Transcription Services at No Cost

User-Friendly Work Portal

Enhanced Industry Expertise

Qualifications

• Must be Board Certified in Neurology and hold a valid FL license.
• Experience in medical necessity and utilization review required.

Responsibilities

• Review medical records and provide interpretations based on guidelines.
• Ensure clear documentation and timely case returns.

Skills

Clinical Expertise

Medical Necessity Review

Insurance Appeals

Evidence-Based Guidelines

Credentialing

Education

Board Certification in Neurology

Active Florida Medical License

Tools

Medical Records Review

Transcription Services

User-Friendly Work Portal

Job description

Dane Street is expanding our physician panel! This is a telework opportunity for supplemental income for physicians providing a caseload customized to your schedule. Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case basis.

The ideal candidates will hold a FL license and be Board Certified in Neurology.

Independent Medical Exam must be completed within 10 miles of Panama City, Florida.

As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and review insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client specific policies, nationally recognized evidence-based guidelines, and standards of care.

MAJOR DUTIES AND RESPONSIBILITIES:

• Reviews all medical records and addresses each question posed by the client utilizing client specific criteria or other nationally recognized evidence-based criteria.
• Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision.
• Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes.
• Provides copies of any criteria utilized in a review with the report in a timely manner.
• Returns cases on or before the due date and time.
• Makes telephone calls as mandated by the state and/or client specifics.
• Maintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the job.
• Attends all required orientation and training.
• Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits.
• Board certification required, active practice required.

PLEASE BE AWARE: In the interest of the security of all parties, Dane Street will never conduct interviews via 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.
• Enhanced industry expertise strengthening your medical practice 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 flow, transcription services at no cost, and user-friendly work portal.

Dane Street supports all referral processes, scheduling, preps cases extensively, prepares all medical records, provides transcription services as applicable, facilitates all client communications, and ensures the quality and timeliness of all reports and report delivery.