Board Certified Internal Medicine Physicians for IME Cases- Stockton, CA

Dane Street, LLC; Stockton (CA); On-site; USD 75,000 - 125,000; Part time

Benefits offered by this job

Schedule flexibility

Robust supplemental income opportunity

Job summary

Dane Street, LLC is expanding its physician panel in Stockton, California, seeking Board-Certified physicians for a reviewer/advisor role. This position offers robust opportunities for supplemental income with a flexible schedule.

The ideal candidates must hold a valid CA license and Board Certification in Physical Medicine, Internal Medicine, Family Medicine, or Occupational Medicine. Responsibilities include reviewing insurance claims and providing advisory-only opinions.

Qualifications

• CA medical license is required.
• Board Certification in Physical Medicine, Internal Medicine, Family Medicine, or Occupational Medicine is essential.
• Active practice required.

Responsibilities

• Review insurance appeals and claims using clinical expertise.
• Maintain proper credentialing and state licenses.
• Provide clear rationale for medical necessity determinations.
• Attend all required orientation and training.

Skills

Clinical expertise

Medical necessity interpretation

Insurance claim review

Experience in Physical Medicine

Education

CA medical license

Board Certification in relevant fields

Job description

Overview

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 Physical Medicine and Rehabilitation, Internal Medicine, Family Medicine, or Occupational Medicine. We are searching for providers within the Stockton area in the state of California.

Responsibilities

• As Physician Reviewer/Advisor, utilize clinical expertise and review insurance appeals, and prospective and retrospective claims. 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.
• Review all medical records and address each question posed by the client using client-specific criteria or other nationally recognized evidence-based criteria.
• Ensure that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision.
• Identify, critique, and utilize current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature to support sound and objective decision-making; refrain from using case studies or cohorts with limited sample sizes.
• Provide copies of any criteria utilized in a review with the report in a timely manner.
• Return cases on or before the due date and time.
• Make telephone calls as mandated by the state and/or client specifics.
• Maintain proper credentialing and state licenses and any special certifications or requirements necessary to perform the job.
• Attend all required orientation and training.
• Perform 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 and Opportunity

• 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.