Board-Certified Physicians for IME Cases- Alaska

About the role

Dane Street is expanding our physician panel to offer an in-person opportunity for supplemental income. Physicians will provide a customized caseload based on their schedule.

Responsibilities

• Utilize clinical expertise to review insurance appeals, prospective and retrospective claims
• Interpret medical necessity of services provided by other healthcare professionals in compliance with client-specific policies, nationally recognized evidence-based guidelines, and standards of care
• Address questions posed by the client using client-specific criteria or other nationally recognized evidence-based criteria
• Ensure the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision
• Identify, critique, and utilize current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature to support sound and objective decision-making and rationales in reviews
• Provide 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

Requirements

• Hold an AK license
• Be Board Certified in Physical Medicine and Rehabilitation, Internal Medicine, Orthopedic Surgery, Occupational Medicine, Neurology, or Psychiatry

Qualifications

• Major Duties and Responsibilities as outlined above

Skills

• Strong clinical expertise
• Ability to interpret medical necessity
• Knowledge of nationally recognized evidence-based guidelines and peer-reviewed literature

Benefits

• Robust opportunity for supplemental income
• Schedule flexibility and predictable work hours
• No doctor/patient relationship is established and no treatment is provided. These are advisory-only opinions.
• Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management expertise
• Expanded credentials as an expert in Independent Medical Exams and physician advisor services
• Fully prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal

Pay

Details about pay are not specified in the posting.

Schedule

Details about the schedule are not specified in the posting.