Board Certified-(M.D, D.O) Pittsburg, KS Oncology Advisor-Certified for IME

Major Duties and Responsibilities

• Reviews all medical records and addresses each question posed by the client utilizing client specific criteria or other nationally recognized evidence-based criteria
• Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision
• Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews
• Provides copies of any criteria utilized in a review with the report in a timely manner
• Returns cases on or before the due date and time
• Makes telephone calls as mandated by the state and/or client specifics
• Maintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the job
• Attends all required orientation and training
• Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits

Qualifications

• Board certification required
• Active practice required

Skills

• Expertise in clinical reviews and interpretations of medical necessity
• Ability to interpret and apply nationally recognized evidence-based guidelines and standards of care
• Knowledge of relevant state and professional association guidelines and peer-reviewed literature
• Strong communication skills, both written and verbal
• Proficiency in utilizing electronic medical record systems and other relevant software

Benefits

• Robust opportunity for supplemental income
• Schedule flexibility and predictable work hours
• No doctor/patient relationship is established and no treatment is provided
• Enhanced industry expertise strengthening your medical practice
• Expanded credentials as an expert in Independent Medical Exams and physician advisor services
• Prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal