- Reviews all medical records and addresses each question posed by the client utilizing state-mandated 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
- Returns cases on or before the due date and time
- 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
- 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
- Conducts Independent Medical Exams in a clean, safe, professional manner and setting
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Mid-Atlantic Permanente Medical Group Virginia, United States Full timeThe Mid-Atlantic Permanente Medical Group (MAPMG) proudly provides the highest quality integrated care for over 800,000 members in Virginia, Maryland, and the District of Columbia. We invite applications for a full-time specialist in Anesthesiology at our NOVA Service Area. · In ...
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Healthcare Staffing Solutions, Inc Virginia, United StatesVirginia s Chesapeake Bay area seeks additional Rads · Premier group of 45 Radiologists is seeking additional Radiologists. Open to both Partnership and employee positions. For partnership track positions salary will be competitive and call is as follows: week nights are covered ...
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Pinnacle Health Group Charleston, United StatesJoin one of the best health care providers and academic medical centers in the state · In-patient Infectious Disease · Join a largely inpatient Hospital ID practice of 6 full-time / 2 part-time physicians and 3 supporting NP s · Weekend / holiday call is a 1 in 6+ schedule with ...
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SMR Group Ltd Charleston, United States PermanentOur emerging medical device client is launching disruptive new device that has demonstrated significant benefits through more than a decade of clinical research and use. Studies show that patients benefit from significantly reduced disc reherniations and reoperations – and the as ...
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Pinnacle Health Group Charleston, United States Full timeJoin one of the best health care providers and academic medical centers in the state · In-patient Infectious Disease · * Join a largely inpatient Hospital ID practice of 6 full-time / 2 part-time physicians and 3 supporting NP ́s · * Weekend / holiday call is a 1 in 6+ schedule w ...
Pulmonary, Pain Management, Ortho Spine Physician - Charleston, United States - Dane Street, LLC
Description
Job Description
Job DescriptionDescription
Dane Street, a certified "Great Place to Work" company, is in search of a Board Certified Orthopaedic Surgeon (Lumbar Spine), Pulmonary Disease and Pain Management physician to conduct Independent Medical Exams (IME) and Peer Reviews. Preferred candidates will hold a West Virginia license. Worker's Compensation experience is required. This opportunity provides the ability to customize your schedule and caseload within a standard Monday - Friday work week while maintaining client-mandated turnaround times. We will reach out when we have an IME or Peer Review in your jurisdiction/area to schedule or assign a case. Our reviewers are compensated on a per-case basis as a 1099 independent contractor.
JOB SUMMARY:
Utilizes clinical expertise, and reviews workers' compensation claims by providing an interpretation of the medical appropriateness of services provided by other healthcare professionals in compliance with state regulations and guidelines, nationally recognized evidence-based guidelines, client-specifics, policies, procedures, performance standards, and URAC guidelines.
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.
