As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client-specific policies, nationally recognized evidence-based guidelines, and standards of care.
MAJOR DUTIES AND RESPONSIBILITIES:
Please be aware that, in the interest of all parties, Dane Street won't conduct interviews via text or request checks from candidates for any reason, including the purchase of equipment.
Benefits
Benefits
The Medical Clinical Review Consultant conducts independent evaluations of healthcare claims, assessing medical necessity and quality of care to ensure compliance with Medicaid policies.
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