Remote Anesthesiologist Medical Reviewer Flexible 20 hrs/wk

Concentra; New York (NY); A distancia; USD 207.000 - 344.000; A tiempo parcial

Descripción de la vacante

Concentra is seeking an accomplished Board Certified Anesthesiologist for our medical reviewstream division. This telecommute, 1099 independent contractor role offers a customizable schedule and caseload within a Monday–Friday work week and business hours.

Candidates must hold a New Mexico MD license and average about 20 hours per week in active patient care. The physician will review health claims, determine medical necessity, and ensure compliance with Concentra policies and URAAC guidelines.

Formación

• Board certified MD/DO with good standing in network services and credentialing.
• Current, unrestricted medical license(s).
• Board certification by ABMS or ABO is required for MD or DO reviewer.
• Must be in active medical practice to perform appeals.

Responsabilidades

• Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, disability, FMLA, workers’ compensation.
• Meet with Medical Director to discuss quality of care and credentialing/state licensure issues.
• Maintain credentialing and state licenses and any necessary certifications.
• Provide clear rationales and documented criteria for cases.
• Contact providers telephonically and discuss applicable decision process and appeal options.

Conocimientos

Telemedicine

Computer skills

Communication

Negotiation

Educación

MD/DO Board Certified

Active medical license

ABMS/ ABO board certification

Descripción del empleo

Concentra is seeking an accomplished Board Certified Anesthesiologist for our medical reviewstream division. This telecommute, 1099 independent contractor role offers a customizable schedule and caseload within a Monday–Friday work week and business hours.

Candidates must hold a New Mexico MD license and average about 20 hours per week in active patient care. The physician will review health claims, determine medical necessity, and ensure compliance with Concentra policies and URAAC guidelines.