Remote Physician Reviewer (NM Licensed) - Multi-Specialty

Dane Street; United States; À distance; USD 83 000 - 165 000; Temps partiel

Résumé du poste

Dane Street is seeking a physician reviewer to work remotely as an independent contractor in the United States. The role involves reviewing insurance appeals and claims to determine medical necessity in line with client policies and evidence-based guidelines.

The reviewer will interpret records across specialties and produce well-reasoned determinations with transparent documentation, while maintaining licensure and credentialing standards.

Qualifications

• Active New Mexico medical license required.
• Experience interpreting medical necessity per client policies and guidelines.
• Ability to review insurance appeals and clinical documentation.

Responsabilités

• Review medical records and client questions using specified criteria.
• Provide clear, concise rationale with supporting documentation.
• Maintain credentialing and licensure requirements to perform reviews.
• Meet due dates and communicate findings to clients.

Connaissances

Active NM License

Clinical expertise

Medical necessity reviews

Formation

Medical doctor license

Outils

Medical guidelines access

Description du poste

Dane Street is seeking a physician reviewer to work remotely as an independent contractor in the United States. The role involves reviewing insurance appeals and claims to determine medical necessity in line with client policies and evidence-based guidelines.

The reviewer will interpret records across specialties and produce well-reasoned determinations with transparent documentation, while maintaining licensure and credentialing standards.