- 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
- 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
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LocumJobsOnline West Palm Beach, United States Full timeLocumJobsOnline is working with All Star Healthcare Solutions to find a qualified Orthopedic Surgery MD in Florida · About The Position · Orthopedic Spine Surgeon opening in South Florida. ID# 56935 · Job details: · BC/BE Orthopedic Spine · Multi-specialty Orthopedic group · 4 Or ...
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United Surgical Partners International Inc (USPI) West Palm Beach, United StatesHospital for Special Surgery (HSS) is the world's leading academic medical center focused on musculoskeletal health. · United Surgical Partners International (USPI) is a company that specializes in the development and operation of Ambulatory Surgical Centers (ASCs) in the U.S. an ...
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Locum Physician
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LocumJobsOnline West Palm Beach, United States Full timeLocumJobsOnline is working with All Star Healthcare Solutions to find a qualified Orthopedic Surgery MD in Florida · About The Position · All Star Healthcare Solutions is working with a hospital in Florida that will be needing an ortho trauma surgeon or a General Orthopedic Surge ...
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Tenet Healthcare West Palm Beach, United StatesPalm Beach Health Network Physician Group is seeking an BC/BE Advanced Gastroenterologist to join our multi-specialty network at Good Samaritan Medical Center in beautiful West Palm Beach, FL. GSMC is a 333-bed acute care hospital offering a broad range of services including comp ...
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Fulltime CRNA
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Envision Physician Services Palm Beach, FL, United States Full timeThe Palms Wellington Surgery Center is a state-of-the-art surgical facility serves residents of the western communities of Palm Beach County, providing same-day, outpatient surgery in Royal Palm Beach, Florida. Our operating rooms and recovery suites offer the most sophisticated ...
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Center for Orthopedic and Research Excel West Palm Beach, United StatesJob Description · Job DescriptionCenter for Bone & Joint Surgery is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the musculoskeletal system. All our facilities feature highly trained orthopedic surgeons, each with a specific ...
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CRNA - Fulltime
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Envision Physician Services Palm Beach, FL, United States Full timePremier CRNA opportunity with Lucrative Compensation and Work-Life Balance at Laser and Surgery Center of the Palm Beaches - $75K Start Date Bonus · Envision Physician Services is currently seeking a qualified CRNA for a full-time opportunity at Laser and Surgery Center of the Pa ...
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Neurosurgery Locum
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Pacific Companies, Inc. West Palm Beach, FL, United StatesThe Orthopedic Surgery locum tenens opportunity in Florida.-Duration: December March (possibility of extension)-Location: West Palm Beach, FL-Schedule: 2 weeks per month-Shift: 24 hour call, 7a-7a-Scope: Adult and Peds -Patient volume: 5-7 adult in person consults per shift, 3-6 ...
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Front Office Representative
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Center for Orthopedic and Research Excel West Palm Beach, United StatesJob Description · Job DescriptionCenter for Bone & Joint Surgery is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the body's musculoskeletal system. Our locations feature a staff of highly trained orthopedic surgeons, each wi ...
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West Palm Beach, FL
3 weeks ago
Pacific Companies West Palm Beach, United StatesThe Orthopedic Surgery locum tenens opportunity in Florida . · -Duration: December March (possibility of extension) · -Location: West Palm Beach, FL · -Schedule: 2 weeks per month · -Shift: 24 hour call, 7a-7a · -Scope: ER Call · -Patient volume: high · -EMR: Epic · -Hosp ...
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Anesthesiology - CRNA
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Envision Physician Services Palm Beach, United StatesThe Palms Wellington Surgery Center is a state-of-the-art surgical facility serves residents of the western communities of Palm Beach County, providing same-day, outpatient surgery in Royal Palm Beach, Florida. Our operating rooms and recovery suites offer the most sophisticated ...
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Surgery Scheduler-Royal Palm Beach
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Center for Orthopedic and Research Excel West Palm Beach, United StatesJob Description · Job DescriptionCenter for Bone & Joint Surgery of the Palm Beaches is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the body's musculoskeletal system. Our locations feature a staff of highly trained orthoped ...
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Vascular Surgery job in West Palm Beach FL
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HCA San Francisco, United States PermanentDescription · Specialization: · Surgery Vascular · Job Summary: · HCA East Florida Vascular surgery and JFK North Hospital is seeking a Vascular Surgeon to join Florida Heart and Vascular Care. · Qualified Candidates: Fellowship training required · Must be board-certified or bo ...
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Operating Room Nurse PRN
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USPI West Palm Beach, United StatesPalm Beach International Surgery Center , is seeking a motivated OR Registered Nurse to join our team. Palm Beach International Surgery Center is a fast paced ASC environment committed to producing the highest quality work and experience for patients and their families. · J ...
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Ultrasound Sonographer- 2 day a week
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Center for Orthopedic and Research Excel West Palm Beach, United StatesJob Description · Job DescriptionCenter for Bone & Joint Surgery is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the body's musculoskeletal system. Our locations feature a staff of highly trained orthopedic surgeons, each wi ...
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Pathology Anatomic and Clinical Medical Director
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HCA Physician Services West Palm Beach, United StatesDescription · Specialization: · Pathology Anatomic and Clinical · Job Summary: · HCA Healthcare Pathology Services and it's East Florida Division is seeking a Medical Director to oversee and be based at HCA Florida JFK North Hospital. This hospital is located in West Palm Beach, ...
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Registered Nurse RN Day Surgery
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HCA Florida JFK North Hospital West Palm Beach, United StatesJob Description · Description · IntroductionDo you currently have an opportunity to make a real impact with your work? With over 2,000 sites of care and serving over 31.2 million patient interactions every year, nurses at HCA Florida JFK North Hospital have the opportunity to mak ...
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Palm Beach Health Network Physician Group
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Tenet Healthcare West Palm Beach, FL, United StatesPalm Beach Health Network Physician Group is seeking an BC/BE Advanced Gastroenterologist to join our multi-specialty network at Good Samaritan Medical Center in beautiful West Palm Beach, FL. GSMC is a 333 acute care bed hospital that offers a broad range of services includin ...
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Gastroenterology Physician
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HCA West Palm Beach, United StatesSpecialization: · Gastroenterology · Job Summary: · HCA Florida JFK North Hospital is seeking a Board Eligible/Board Certified Gastroenterologist. · Qualified Candidates: · * BE/BC in Gastroenterology · * Responsibilities will include providing care to patients in the clinic & ho ...
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Surgical Physician Assistant
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SpecialtyCare West Palm Beach, FL, United StatesSurgical Physician Assistant · Surgical Physician Assistant · As a Surgical Physician Assistant with SpecialtyCare you will act as a First Assistant to the surgeon(s) during surgical procedures and perform complex surgical techniques as needed and directed by the physician. In t ...
Physician Reviewer: Orthopedic Surgery - West Palm Beach, United States - Dane Street, LLC
Description
Job Description
Job DescriptionThis telework opportunity provides the ability to customize your schedule and caseload within the week while maintaining client-mandated turnaround times. Our reviewers are compensated on a per-case basis as a 1099 independent contractor.
Preferred candidates will hold a TX license.
JOB SUMMARY
Utilizes clinical expertise, and reviews insurance appeals, 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:
PLEASE BE AWARE: In the interest of the security of both parties, please be aware that Dane Street will never conduct an interview via text or request checks from candidates for purchasing equipment.
