Board-Certified Neurological Surgeon for IME

Dane Street; Minneapolis (MN); On-site; USD 300,000 - 400,000; Full time

Job summary

A leading company is seeking a Board-Certified Neurological Surgeon to serve as a Physician Reviewer/Advisor for Independent Medical Exams (IME). This role involves reviewing insurance appeals and claims, interpreting medical necessity, and ensuring compliance with guidelines. The position offers flexibility, supplemental income opportunities, and no direct patient care, allowing you to enhance your expertise in medical necessity and utilization review.

Benefits

Opportunity for supplemental income

Flexible schedule

Control over services and case types

Enhance industry expertise

Expand credentials as an IME

Qualifications

• Board certification and active practice are required.
• Utilize clinical expertise to review insurance appeals and claims.

Responsibilities

• Review all medical records and address client questions using evidence-based criteria.
• Ensure rationale for decisions is clear and well-supported.
• Complete cases by the due date and time.

Skills

Clinical Expertise

Medical Necessity Interpretation

Evidence-Based Guidelines

Education

Board Certification

Active Medical License

Job description

Board-Certified Neurological Surgeon for IME

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Requirements

As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise to review insurance appeals and claims, both prospective and retrospective. Your role involves interpreting the medical necessity of services provided by healthcare professionals, 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 client-specific or nationally recognized evidence-based criteria.
2. Ensure the rationale for decisions is clear, concise, and well-supported with documentation.
3. Utilize current criteria and resources such as national, state, and professional guidelines, peer-reviewed literature, avoiding limited-sample case studies.
4. Provide copies of criteria used in reviews promptly.
5. Complete cases by the due date and time.
6. Make mandated telephone calls as required.
7. Maintain proper credentials, licenses, and certifications necessary for the role.
8. Attend all required training and orientation.
9. Perform additional duties including responding to quality assurance issues, complaints, regulatory matters, depositions, court appearances, or audits.
10. Board certification and active practice are required.

Note: Dane Street will never conduct interviews via text or request checks for equipment purchases to ensure security.

Benefits:

• Opportunity for supplemental income
• Flexible schedule and predictable hours, with control over services and case types
• No doctor-patient relationship or treatment involved; advisory-only opinions
• Enhance industry expertise in medical necessity and utilization review
• Expand credentials as an IME and physician advisor
• Streamlined case handling with prepped cases, transcription services, and user-friendly portal

Dane Street supports referral processes, scheduling, case preparation, client communication, and report quality and delivery.