Board Certified Internal Medicine Physicians for IME Cases- Delaware

Dane Street, LLC; Seaford (DE); On-site; USD 100,000 - 150,000; Part time

Job summary

Dane Street, LLC is expanding our physician panel with an in-person opportunity for physicians to provide supplemental income on a per-case basis. Independent contract reviewers (1099) are sought in Delaware who can schedule around their practice.

The selected Physician Reviewer/Advisor will assess medical necessity, review insurance appeals and claims, and interpret guidelines in line with client policies and nationally recognized standards of care.

Qualifications

• CA medical license required.
• Board certification in Internal Medicine, Family Medicine, or Occupational Medicine.
• Active medical practice in Delaware.
• Independent contractor (1099) status.
• In-person, schedule-flexible opportunity.

Responsibilities

• Reviews medical records and answers client questions using client-specific criteria.
• Ensures rationale for determination is clear and well documented.
• Identifies and uses current criteria and literature to support decisions.
• Provides copies of criteria used with the report.
• Returns cases by the due date and makes mandated calls.
• Maintains credentialing and state licenses and any required certifications.
• Attends orientation and training.
• Performs other duties including QA, regulatory issues, audits.
• Board certification required, active practice required.

Skills

CA License

Board Certification

Job description

Dane Street is expanding our physician panel! This is an in-person 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 CA license and be Board-Certified in Internal Medicine, Family Medicine, or Occupational Medicine. We are searching for providers within the state of Delaware.

As Physician Reviewer/Advisor, you will utilize clinical expertise and reviews 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.

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.