Board-Certified Physicians for IME Cases- Washington

Dane Street, LLC; Seattle (WA); On-site; USD 200 - 500; Part time

Benefits offered by this job

In-person opportunity

Supplemental income

1099 independent contractor

Job summary

A leading healthcare consulting firm in Seattle is seeking a Physician Reviewer/Advisor to evaluate insurance appeals and claims. The ideal candidate will be a WA licensed and board-certified physician with expertise in various medical fields. This role offers flexible hours and supplemental income by allowing you to tailor your workload. Responsibilities include reviewing medical records and maintaining compliance with guidelines. If you are an experienced physician eager to contribute in an advisory capacity, we welcome your application.

Qualifications

• Must hold a WA license and be Board Certified in relevant fields.
• Experience in reviewing medical records and understanding insurance criteria.
• Ability to maintain proper credentialing and certifications.

Responsibilities

• Review medical records and provide interpretations of medical necessity.
• Utilize evidence-based guidelines in decision-making.
• Ensure timely return of cases and maintain necessary credentials.
• Provide copies of criteria used with reports.
• Return cases by due dates and times.
• Make required telephone calls as per state/client rules.
• Maintain credentialing and licenses needed for the role.
• Attend orientation and training; perform other duties including QA, regulatory issues or audits.

Skills

Clinical expertise

Board Certification

Understanding of medical necessity

Reviewing insurance appeals

Education

WA medical license

Board certification in Internal Medicine

Board certification in Orthopedic Surgery

Board certification in Occupational Medicine

Board certification in Neurology

Board certification in Psychiatry

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 WA license and be Board Certified in Physical Medicine and Rehabilitation, Internal Medicine, Orthopedic Surgery, Occupational Medicine, Neurology, or Psychiatry. We are searching for providers throughout the state of Washington.

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.

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