Remote Orthopedic Surgeon (Contract) — Per-Case Pay

Concentra, Inc

Chicago (IL)

On-site

USD 240,000 - 360,000

Full time

14 days+

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Job summary

Concentra, Inc. seeks an experienced Board Certified Orthopedic Surgeon for our medical reviewstream division.

This telecommute role allows you to customize your schedule and caseload within a Monday–Friday work week and business hours, with compensation on a per-case basis as a 1099 independent contractor. Candidates must hold an IL MD license and be in active medical practice to perform appeals, with responsibility for reviewing health claims and ensuring compliance with Concentra policies and

Qualifications

Board cert MD/DO with an excellent understanding of network services and managed care, utilization of services and credentialing, quality assurance and policy development.
Current, unrestricted clinical license(s) and process for restricted licenses.
Board certification by ABMS or AOAS is required for MD/DO reviewer.
Active medical practice to perform appeals.
Evidence of current error and omissions liability coverage for job duties.
Managed care orientation and knowledge of current practice standards in specialty.

Responsibilities

Reviews medical files and provides recommendations for utilization review, medical necessity, and appropriateness of care.
Collaborates with the Medical Director to discuss quality of care and credentialing issues.
Maintain credentialing and state licenses and any required certifications.
Communicate with providers regarding criteria, risk, and appeal processes.
Identify and respond to quality assurance issues and regulatory matters.