Oncology - Radiation Physician

Dane Street; Washington (District of Columbia); Remote; USD 125,000 - 150,000; Part time

Job summary

A health services company is seeking independent contractor physician reviewers to provide medical record reviews remotely. You will customize your schedule while meeting client turnaround times. Required qualifications include certification maintenance and experience in clinical review. This position offers flexibility and the ability to work from home.

Qualifications

• Certification and credentialing maintenance as required by the role.
• Ability to work remotely with a flexible schedule and meet client turnaround times.
• Experience in clinical review, medical necessity interpretation, and adherence to evidence-based guidelines.

Responsibilities

• Provide reviews of medical records and address client questions.
• Ensure rationale for determinations is clear and supported by documentation.
• Maintain proper credentialing and attend required training.

Skills

Clinical review

Medical necessity interpretation

Remote work flexibility

Job description

Overview

This telework opportunity allows you to customize your schedule and caseload within the week while maintaining client-mandated turnaround times. Our reviewers are compensated on a per-case basis as a 1099 independent contractor.

Responsibilities

• All physician reviewers are contractors with Dane Street.
• Provide reviews of medical records and address each client question using client-specific criteria or other nationally recognized evidence-based criteria.
• Ensure that the rationale for the determination is clear, concise, and supported by adequate documentation.
• Identify, critique, and utilize current criteria and resources such as national, state, and professional guidelines and peer-reviewed literature to support sound, objective decision-making; avoid overreliance on studies with limited sample sizes.
• Provide copies of any criteria utilized in a review with the report promptly.
• Make telephone calls as mandated by the state and/or client specifics; Peer to Peer calls may be required (Dane Street can help arrange).
• Average review time per case is typically 15-30 minutes; cases are prepared before review.
• Some cases may require a short turnaround time and may need to be reviewed the same day; return cases on or before the due date and time.
• Maintain proper credentialing, state licenses, and any special certifications required to perform the job; attend all required orientation and training.
• Perform other duties as assigned, including addressing quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits.

Qualifications and Requirements

• Certification and credentialing maintenance as required by the role.
• Ability to work remotely with a flexible schedule and meet client turnaround times.
• Experience in clinical review, medical necessity interpretation, and adherence to client-specific policies and general evidence-based guidelines.

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