Remote Spine Medical Review Physician - Flexible Schedule

Concentra; Albuquerque (NM); Remote; USD 90,000 - 150,000; Full time

Job summary

Concentra seeks experienced physicians for its medical review stream division. This telecommute role allows you to tailor your schedule and caseload as a 1099 independent contractor, with a Monday–Friday work week and business hours. A New Mexico license is required to participate as a Spine Surgeon reviewer.

Job involves reviewing medical claims for medical necessity, appropriateness of care, and return-to-work decisions in line with Concentra policies and URAAC guidelines.

Qualifications

• Board-certified MD/DO with licenses and credentialing.
• Active, unrestricted medical license(s) to perform reviews and appeals.
• ABMS/ABOS board certification required for MD/DO reviewers.
• Active clinical practice status to perform appeals.

Responsibilities

• Review medical files and provide recommendations on utilization review and medical necessity.
• Consult with Concentra Physician Review Medical Director on quality of care and licensure issues.
• Maintain credentialing and state licenses and any required certifications.
• Provide timely case returns with clear rationales and criteria.

Skills

Demonstrated computer skills

Demonstrated review ability

Negotiation/communication

Education

Board certified MD/DO

Active medical license

ABMS/ABOS board certification

Active medical practice

Job description

Concentra seeks experienced physicians for its medical review stream division. This telecommute role allows you to tailor your schedule and caseload as a 1099 independent contractor, with a Monday–Friday work week and business hours. A New Mexico license is required to participate as a Spine Surgeon reviewer.

Job involves reviewing medical claims for medical necessity, appropriateness of care, and return-to-work decisions in line with Concentra policies and URAAC guidelines.