Remote Physician Reviewer, Orthopedic Surgery

Summary

Join a fast-paced Inc. 500 Company with a high-performance culture, seeking insightful professionals to review insurance claims for leading national and regional carriers.

Requirements

• Must be an Orthopedic Surgeon in the Dallas or Houston area
• Hold a TX License
• Have testimony/deposition/counter affidavit work experience
• Have access to a TX notary or be readily available for online notaries

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 in a timely manner
• Returns cases on or before the due date and time

Benefits

• Paid Time Off
• Excellent benefits package
• Competitive salary
• Apple equipment and media stipend for remote work space