Independent Medical Exam IME Doctor- Board-Certified Ortho Surgery (M.D., D.O.)

Responsibilities

• Utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims.
• 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.
• 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.
• 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

• Hold a NY license.
• Be based in Erie County, NY.
• Be Board Certified in Orthopedic Surgery, with experience in completing Independent Medical Exams.
• Be New York State Workers' Comp certified.

Benefits

• Robust opportunity for supplemental income.
• Schedule flexibility and predictable work hours - You choose services and case types, dictate volume, and conduct exams and reviews based on your schedule availability.
• 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.
• Prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal.