Board Certified Internal Medicine Physicians for IME Cases- Delaware

Dane Street, LLC • Seaford, DE

7h • Onsite

About The Position

Dane Street is seeking Board Certified Internal Medicine Physicians for Independent Medical Exams (IME) cases in Delaware. This is an in-person opportunity for supplemental income, offering a caseload customized to your schedule. As a Physician Reviewer/Advisor, you will utilize your clinical expertise to review insurance appeals, and prospective and retrospective claims. You will provide interpretations of the medical necessity of services, adhering to client-specific policies, nationally recognized evidence-based guidelines, and standards of care. This role does not involve direct patient care or treatment, but rather advisory-only opinions.

Requirements

• Board Certified in Internal Medicine, Family Medicine, or Occupational Medicine
• Active practice required
• Must hold a CA license
• Must be a provider within the state of Delaware
• Maintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the job

Nice To Haves

• Board certification required

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

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

• Job Type: Part-time
• Career Level: Senior