Remote NM Licensed Physician Reviewer (Per-Case Contractor)

Dane Street; United States; A distancia; USD 83.000 - 165.000; Jornada completa

Descripción de la vacante

Dane Street offers a remote physician reviewer role allowing you to customize your weekly schedule and caseload. This is a 1099 independent contractor position requiring an active NM medical license and provides review of medical records and insurance claims according to client policies.

The reviewer interprets medical necessity using evidence-based guidelines and ensures documentation is thorough and timely, while maintaining credentialing and license requirements.

Formación

• Must hold an active NM License.
• Experience reviewing medical records and applying clinical criteria.

Responsabilidades

• Reviews all medical records and addresses each client question using criteria.
• Ensures the rationale for the determination is clear and well-documented.
• Identifies and uses current guidelines and peer-reviewed literature to support decisions.
• Provides copies of criteria used in reviews with the report.

Conocimientos

Medical review

Policy interpretation

Clinical criteria

Documentation

Educación

Active NM Medical License

Descripción del empleo

Dane Street offers a remote physician reviewer role allowing you to customize your weekly schedule and caseload. This is a 1099 independent contractor position requiring an active NM medical license and provides review of medical records and insurance claims according to client policies.

The reviewer interprets medical necessity using evidence-based guidelines and ensures documentation is thorough and timely, while maintaining credentialing and license requirements.