Remote Orthopedic Surgeon—Medical Review (Contract)

Concentra, Inc.; Secaucus (NJ); Remote; USD 65,000 - 110,000; Full time

Job summary

Concentra, Inc. is seeking a Board Certified Orthopedic Surgeon for a telecommute medical review role. This is a 1099 independent contractor position reviewing health claims, providing medical interpretation, and making decisions in line with Concentra Physician Review policies and URAAC guidelines.

The ideal candidate must hold a NJ medical license and be active in clinical practice to perform appeals. Schedule is Monday–Friday within business hours, with compensation on a per-case basis.

Qualifications

• Board certified MD/DO with an excellent understanding of network services and managed care.
• Current, unrestricted clinical license(s) required.
• Board certification by American Board of Medical Specialties or American Board of Osteopathic Specialties is required.
• Active medical practice to perform appeals.

Responsibilities

• Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, and appropriateness of care.
• Determines return to work, disability, and FMLA considerations; discusses quality of care with Medical Director as needed.
• Maintains credentialing and state licenses; prepares timely, clear rationales and criteria.
• Communicates with providers and other health professionals; explains applicable disclaimers and appeal processes.
• Identifies and uses current guidelines and literature to support review decisions.

Skills

Board Certified Orthopedic Surgeon

Education

MD/DO board certified

Job description

Concentra, Inc. is seeking a Board Certified Orthopedic Surgeon for a telecommute medical review role. This is a 1099 independent contractor position reviewing health claims, providing medical interpretation, and making decisions in line with Concentra Physician Review policies and URAAC guidelines.

The ideal candidate must hold a NJ medical license and be active in clinical practice to perform appeals. Schedule is Monday–Friday within business hours, with compensation on a per-case basis.