Board Certified Internal Medicine Physicians for IME Cases- Delaware

Dane Street • Seaford, DE

68d • Onsite

About The Position

Dane Street is expanding its physician panel with an in-person opportunity for supplemental income. This role is for independent contract reviewers (1099) who will be compensated on a per-case basis. The ideal candidates will hold a CA license and be Board-Certified in Internal Medicine, Family Medicine, or Occupational Medicine. We are searching for providers within the state of Delaware.

Requirements

• Board certification required
• Active practice required
• CA license (preferred, but searching for providers within the state of Delaware)
• Board-Certified in Internal Medicine, Family Medicine, or Occupational Medicine

Nice To Haves

• CA license

Responsibilities

• Utilize clinical expertise to review 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.
• Review all medical records and address each question posed by the client utilizing client specific criteria or other nationally recognized evidence-based criteria.
• Ensure that 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 that 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.
• Return cases on or before the due date and time.
• Make telephone calls as mandated by the state and/or client specifics.
• Maintain proper credentialing and state licenses and any special certifications or requirements necessary to perform the job.
• Attend all required orientation and training.
• Perform other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits.

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
• Fully prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal

What This Job Offers

• Career Level: Senior