Remote Neurosurgeon Medical Review Specialist (1099)

Concentra, Inc; Dallas (TX); On-site; USD 90,000 - 130,000; Full time

Benefits offered by this job

Telecommute

Flexible schedule

1099 contractor

Job summary

Concentra is seeking a Neurosurgeon Medical Review Stream Physician to perform medical claim interpretations and determinations under Concentra Physician Review policies, procedures, and URAAC guidelines within a telecommute 1099 framework. A TX license and board certification are required, with flexible scheduling to accommodate a Monday–Friday workflow.

The role focuses on health claim reviews, medical necessity, and appropriate care determinations, while maintaining credentialing and

Qualifications

• Board certified MD/DO with understanding of network services and managed care.
• Current, unrestricted TX medical license; Board certification required for MD/DO reviewer.
• Active medical practice to perform appeals.

Responsibilities

• Review medical files and provide recommendations for utilization review, chart reviews, medical necessity, and return to work.
• Coordinate with Concentra Physician Review Medical Director on quality of care and licensure issues.
• Maintain credentialing and state licenses and any required certifications.
• Provide timely, well-reasoned case rationales and criteria.

Skills

Computer skills

Telephonic skills

Review services

Interprofessional collaboration

Conflict-free direction

E&O insurance evidence

Managed care

Practice standards knowledge

Negotiation skills

Education

MD/DO board certified

Active TX medical license

ABMS/AOBS board certification

Active clinical practice

Job description

Concentra is seeking a Neurosurgeon Medical Review Stream Physician to perform medical claim interpretations and determinations under Concentra Physician Review policies, procedures, and URAAC guidelines within a telecommute 1099 framework. A TX license and board certification are required, with flexible scheduling to accommodate a Monday–Friday workflow.

The role focuses on health claim reviews, medical necessity, and appropriate care determinations, while maintaining credentialing and