Diagnostic Radiology- Medical Record Reviewer Job at Dane Street, LLC, Minneapolis, MN

Ykg5eUlHNnlyVEJYQnlvWmVyMDEybi9rN1E9PQ==
  • Dane Street, LLC
  • Minneapolis, MN

Job Description

As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will 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.

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; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes
  • Provides copies of any criteria utilized in a review with the report promptly
  • 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, state licenses, and any special certifications or requirements necessary to perform the job
  • Performs other duties as assigned, including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits
  • Board certification required, active practice required

Please be aware that, in the interest of all parties, Dane Street won't conduct interviews via text or request checks from candidates for any reason, including the purchase of equipment. 

Benefits

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

Job Tags

Extra income,

Similar Jobs

Seasons Kosher Supermarket

Grocery Clerk Job at Seasons Kosher Supermarket

 ...Company Overview Seasons Supermarkets is one of the largest kosher supermarket chains in the nation. At present, there are nine Seasons locations across the Tri-State area with plans to expand. Seasons offers its customers a full-service kosher shopping experience... 

State of Alaska

Emergency Management Specialist 2 (090461) Job at State of Alaska

 ...The Department of Military and Veterans Affairs (DMVA), Division of Homeland Security and Emergency Management (HLS&EM), is recruiting for an Emergency Management Specialist 2 in our Public Assistance Section! This position is in the General Government (GGU) bargaining... 

STAT Informatic Solutions

Document Processing Specialist (Part-Time) Job at STAT Informatic Solutions

 ...for meaningful work? STAT Informatic Solutions is looking for a Document Processing Specialist to join our team. In this role, youll...  ...What Youll Do Receive, prepare, and organize documents for scanning Operate scanners to create high-quality digital files Verify... 

HHI Corporation

Construction Superintendent Job at HHI Corporation

 ...We are seeking a dedicated and experienced Construction Superintendent to join our team in Colorado. In this role, you will be responsible for managing construction projects up to $40 million, working closely with Senior Superintendents and Project Managers. Your primary... 

Greenberg, Traurig, PA

Real Estate Associate — Transactions & Development Job at Greenberg, Traurig, PA

 ...law firm in San Francisco offers a full-time position for a 2nd to 4th year Associate in the Real Estate Practice. Candidates should have 2-4 years of experience in commercial real estate transactions. This role provides competitive compensation and the opportunity to...