Remote Orthopedic Surgeon - Per-Case, Flexible Schedule

Concentra; United States; Remote; USD 120,000 - 240,000; Full time

Job summary

Concentra is seeking an accomplished Board Certified Orthopedic Surgeon for our medical review stream division. This flexible telecommute role lets you tailor your schedule and caseload within a Monday–Friday workweek and business hours, with compensation on a per-case basis as a 1099 independent contractor.

Responsibilities include reviewing health claims, providing medical interpretation, and deciding on the appropriateness of services in line with Concentra policies and URAAC guidelines.

Qualifications

• Board-certified MD or DO with an active US license.
• Current, unrestricted clinical license(s).
• Must be in active medical practice to perform appeals.

Responsibilities

• Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, FMLA, Group health and workers compensation claims.
• Meets with Concentra Physician Review Medical Director to discuss quality of care and credentialing and state licensure issues.
• Maintain proper credentialing and state licenses and any special certifications or requirements.
• Returns cases in a timely manner with clear concise rationale and documented criteria.
• Telephonically contacts providers and interacts with other health professionals in a professional manner.
• Discusses the appropriate DISCLAIMERS and appeal process with the providers.
• Attends orientation and training.
• Performs other duties including responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits.
• Identifies and utilizes current criteria and resources such as national, state, and professional association guidelines and peer reviewed literature that support sound decision making.
• Provides copies of any criteria utilized in a review to a requesting provider in a timely manner.

Skills

Utilization review

Medical decision making

Credentialing

Regulatory knowledge

Professional communication

Education

Board-certified MD/DO with US license

Job description

Concentra is seeking an accomplished Board Certified Orthopedic Surgeon for our medical review stream division. This flexible telecommute role lets you tailor your schedule and caseload within a Monday–Friday workweek and business hours, with compensation on a per-case basis as a 1099 independent contractor.

Responsibilities include reviewing health claims, providing medical interpretation, and deciding on the appropriateness of services in line with Concentra policies and URAAC guidelines.