Orthopedic Surgery- Independent Medical Examiner (IME)

Dane Street, LLC; Orting (WA); On-site; USD 80,000 - 120,000; Full time

Benefits offered by this job

Flexible schedule and predictable hours

No patient relationship established

Access to transcription services and user-friendly portal

Job summary

Dane Street, LLC is seeking a Physician Reviewer/Advisor for Independent Medical Exams (IME). The role involves reviewing medical documentation, ensuring compliance with established guidelines, and delivering expert advisory opinions. This position offers flexibility and opportunities for supplemental income, while enhancing industry expertise in medical necessity and utilization management.

Qualifications

• Must be board certified and actively practicing.
• Strong documentation and compliance skills in medical reviews are essential.

Responsibilities

• Review medical records and interpret necessity of services.
• Deliver timely, well-documented assessments and reports.
• Utilize current guidelines and literature for decision-making.

Skills

Clinical expertise

Compliance with guidelines

Documentation skills

Education

Board certification

Active medical practice

Job description

As a Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize your clinical expertise to review insurance appeals, as well as prospective and retrospective claims. The Physician Reviewer will interpret the medical necessity of services provided by healthcare professionals, ensuring compliance with client-specific policies, nationally recognized 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 criteria or other nationally recognized evidence-based criteria.
2. Ensure that the rationale for each determination is clear, concise, and supported by adequate documentation.
3. Identify, critique, and utilize current criteria and resources such as national, state, and professional association guidelines, as well as peer-reviewed literature, to support sound and objective decision-making. Avoid using case studies or cohorts with limited sample sizes for decision-making.
4. Provide copies of any criteria used in a review along with the report in a timely manner.
5. Return cases on or before the specified due date and time.
6. Make telephone calls as mandated by state and/or client specifics.
7. Maintain proper credentialing, state licenses, and any required certifications.
8. Attend all required orientation and training sessions.
9. Perform other duties as assigned, including addressing quality assurance issues, complaints, regulatory matters, depositions, court appearances, or audits.

Board certification and active practice are required.

PLEASE BE AWARE: In the interest of security, Dane Street will never conduct interviews via text or request checks from candidates for any reason, including the purchase of equipment.

Benefits include:

• Opportunity for supplemental income
• Flexible schedule and predictable work hours—choose services and case types, dictate volume, and conduct exams and reviews based on your availability
• No doctor/patient relationship is established; these are advisory-only opinions
• Enhance your industry expertise in medical necessity and utilization review/management
• Expand your credentials as an expert in IMEs and physician advisor services
• Streamlined case flow, prepped cases, transcription services at no cost, and a user-friendly work portal

Dane Street supports all referral processes, scheduling, case preparation, client communication, and ensures timely report delivery.