- 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 prior to the due time of the case
- 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
-
Physician Reviewer
4 weeks ago
Dane Street Charlotte, United StatesThis 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 NM, TX ...
-
Nurse Practitioner or Physician Assistant
3 weeks ago
MRG Exams Charlotte, United States Full timeWork can be performed by a Nurse Practitioner or Physician Assistant · We are looking for the right Nurse Practitioner or Physician Assistant to perform medical assessments on United States Veterans as part of the VA's disability benefits process. · In performing Disability Asses ...
-
Hospice Medical Director
4 weeks ago
Hospice & Palliative Care Charlotte Region Charlotte, United States Full timeJob Details · Job Location Charlotte, NCPosition Type Full TimeEducation Level Graduate DegreeTravel Percentage Local TravelJob Shift DayJob Category Health Care Description · VIA Health Partners is an industry leader and top-10 nationally ranked provider of end-of-life care. ...
-
Medical Director
1 week ago
Atrium Health Charlotte, United StatesOverview · Job Summary:The Specialty Medical Director - Internal Medicine (Charlotte Market - approx. 200k patients and 160 providers)is responsible for providing leadership in support of the site-based medical directors and the sites within their specialty. There are 3 primary ...
-
Atrium Health Charlotte, United StatesOverview · Job Summary · 1 st · shift weekdays with possibility of weekends. · Floating or at various locations for extended periods of time according to needs · Oversees the provision of safe and effective medication therapies through collaboration with the patients care team. R ...
-
Busy Practice in Charlotte, NC
2 weeks ago
Novant Health Charlotte, United StatesOverview · Novant Health is looking for a compassionate, caring Cardiologist to join our rapidly growing heart & vascular team, and we would love to speak with you about our opportunities. · Are you looking for a new opportunity in a rapidly growing healthcare system that focu ...
-
Atrium Health Charlotte, United StatesOverview · Job Summary · 7:30-4pm,8-430pm, 9-5pm (8 hour days mostly weekdays) · Oversees the provision of safe and effective medication therapies through collaboration with the patients care team. Reviews physician orders for drug therapy and monitors this therapy for drug choi ...
-
Fast-growing Charlotte suburb
2 days ago
Novant Health Charlotte, United StatesOverview · Novant Health is looking for a compassionate, caring Non-Invasive Cardiologist to join our rapidly growing heart & vascular team, and we would love to speak with you about our opportunities. · Are you looking for a new opportunity in a rapidly growing healthcare sys ...
-
Nurse
3 days ago
Metrolina Nephrology Associates Charlotte, United States Full time: · Metrolina has competitive wages and benefits and a generous paid time off package beginning in your first year of employment: *4 weeks (accrued) paid time off PLUS 7 additional paid holidays We also have a generous discretionary profit sharing plan beginning in year 2.* · Met ...
-
Ultrasound Technician
3 weeks ago
N2S Healthcare Staffing Solutions LLC Charlotte, United StatesJob Title: High Risk OB - GYN Ultrasound Technician · Location: Charlotte, NC 28204 · Duration: 13 Weeks (Temp to perm) · Shift: Days, Night. · Positions Available: Ultrasound Tech/ High Risk OB - GYN Ultrasound Technician. · Job Description: · • Performs required Diagnostic Ult ...
-
Nurse Practitioner
2 days ago
Liberty Healthcare Management Charlotte, United StatesLiberty Cares · With Compassion · Liberty Medical Care Services is currently seeking the following: · NURSE PRACTITIONER/PHYSICIAN ASSISTANT · $10k SIGN ON BONUS AVAILABLE · Job Description: · Provides client services to local Skilled Nursing & Rehabilitation facilities. · Assure ...
-
Hospital Liaison, Home Health
2 weeks ago
BAYADA Charlotte, United StatesHospital Liaison / Transitional Care Manager · Are you looking for an exciting opportunity in one of the fastest growing areas of healthcare that will allow you to make a difference in people's lives while you grow your career? We're BAYADA Home Health Care, a leading home healt ...
-
Ultrasound Technician
1 week ago
N2S Healthcare Staffing Solutions LLC Charlotte, United StatesJob Title: OB-GYN Sonographer /Ultrasound Technician (High Risk) · Location: Charlotte, NC 28204 · Duration: 10 Weeks · Shift: 8a-4:30p (8x5) · Job Description: · Performs required Diagnostic Ultrasound procedures. · Assists leadership with clinical and administrative duties. · P ...
-
Contract Specialist
6 days ago
PMMC Charlotte, United StatesJob Title: Contract Specialist · Reports To: Controller · Department: Finance/Admin · About The Team · Our mission at PMMC is to continuously improve the financial performance of healthcare organizations so that they have more resources to devote to patient care. PMMC provides re ...
-
Atrium Health Charlotte, United StatesOverview · Job Summary · 40/hours per week, occasional weekends, and minor holidays · Oversees the provision of safe and effective medication therapies through collaboration with the patients care team. Reviews physician orders for drug therapy and monitors this therapy for drug ...
-
Clinical Advocacy and Support
6 days ago
UnitedHealth Group Charlotte, United States Full timeOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel ...
-
Nurse Practitioner
2 days ago
Liberty Healthcare Management Charlotte, United StatesLiberty Cares · With Compassion · Liberty Medical Care Services is currently seeking the following: · NURSE PRACTITIONER/PHYSICIAN ASSISTANT · $10k SIGN ON BONUS AVAILABLE · Job Description: · Provides client services to local Skilled Nursing & Rehabilitation facilities. · Assure ...
-
Respiratory Therapist
3 weeks ago
Executive Talent Partners Charlotte, United StatesJob Title:Respiratory Therapist · General: Our client, Respire Home Services is seeing a Respiratory Therapist. You will be responsible for assessment of patient/client respiratory equipment needs and the selection, instruction, and troubleshooting of appropriate equipment and/ ...
-
Plasma Center Nurse- RN
3 weeks ago
BioLife Plasma Services Charlotte, NC, United StatesBy clicking the "Apply" button, I understand that my employment application process with Takeda will commence and that the information I provide in my application will be processed in line with Takeda's Privacy Notice and Terms of Use . I further attest that all information I sub ...
-
Sonographer
3 weeks ago
Pride Health Charlotte, United StatesPride Health is hiring Travel Sonographer to support our client's hospital facility in Charlotte, NC. This is a 13-weeks contract role with possible extension opportunity (Travel and local options). · Job Summary: · Performs required Diagnostic Ultrasound procedures. Assists lea ...
Physician Reviewer - Charlotte, 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 NM, TX, MN, and/or NC License.
Physician Specialties: Radiation Oncology, Cardiology, Rheumatology, Ophthalmology, Otolaryngology, OB/GYN, Hematology/Oncology
JOB SUMMARY
Utilizes clinical expertise and reviews insurance appeals, as well as 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:
NOTICE: 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.
