Board Certified OB / GYN- Physician Advisor - Complex Record Review

Dane Street; New York (NY); Remote; USD 100,000 - 125,000; Part time

Job summary

Dane Street is seeking a Physician Reviewer / Advisor for telework opportunities. This role involves reviewing medical records and insurance appeals, utilizing clinical expertise to ensure compliance with guidelines. Physicians can customize their caseloads to fit their schedules while providing critical advisory opinions.

Benefits

Flexible scheduling

Supplemental income opportunities

No doctor-patient relationship

Transcription services at no cost

Qualifications

• Must hold a New York State Medical license.
• Board certification and active practice required.

Responsibilities

• Review all medical records and address client questions using evidence-based criteria.
• Ensure clear rationale for determinations supported by documentation.
• Perform additional duties related to quality assurance and regulatory matters.

Skills

Clinical expertise

Evidence-based decision-making

Analytical skills

Education

New York State Medical license

Board Certified in Obstetrics and Gynecology

Job description

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

The candidate must hold a New York State Medical license and be Board Certified in Obstetrics and Gynecology.

• This role involves complex Record Review; no exam is required.

Requirements

As a Physician Reviewer / Advisor for Independent Medical Exams (IME) / Record Reviews (RR), you will utilize your clinical expertise to review insurance appeals and analyze prospective and retrospective claims. You will interpret the medical necessity of services provided by healthcare professionals, ensuring compliance with client-specific policies, evidence-based guidelines, and standards of care.

Major Duties and Responsibilities:

1. Review all medical records and address each client question using client-specific or nationally recognized evidence-based criteria.
2. Ensure that the rationale for your determinations is clear, concise, and supported by adequate documentation.
3. Utilize current criteria and resources, such as national, state, and professional guidelines, as well as peer-reviewed literature, to support objective decision-making. Avoid using limited-sample case studies or cohorts.
4. Provide copies of utilized criteria along with your review report in a timely manner.
5. Return cases on or before the specified due date and time.
6. Make mandated telephone calls as required by state and client specifics.
7. Maintain proper credentials, licenses, and certifications necessary for the role.
8. Attend all required orientation and training sessions.
9. Perform additional duties as assigned, including addressing quality assurance issues, complaints, regulatory matters, depositions, court appearances, or audits.
10. Board certification and active practice are required.

PLEASE BE AWARE: Dane Street will never conduct interviews via text or request checks from candidates, including for equipment purchases, to ensure security.

Benefits

• Opportunity for supplemental income with flexible scheduling.
• Choose your services, case types, volume, and review times based on your availability.
• No doctor-patient relationship is established; these reviews are advisory-only opinions.
• Enhance your industry expertise in medical necessity and utilization review/management.
• Expand your credentials as an expert in Independent Medical Exams and physician advisory services.
• Enjoy fully prepped cases, streamlined workflows, transcription services at no cost, and a user-friendly work portal.

Dane Street manages referral processes, scheduling, case preparation, medical record collection, client communication, and report quality and timeliness.