Physician Reviewer

Dane Street is looking for individuals to conduct Group Health reviews. This review will include a clinical summary, potential calls to the treating providers, and responses to questions posed.

• The average length of time to review each case is between 15-20 minutes
• The cases are prepared for you before they are provided for your review
• There are times when calls will need to be made
• Dane Street will help arrange any peer to peer phone calls, if needed.

Dane Street is also looking for individuals who would also be interested in participating in Panel Hearing calls. These calls require the physician to dedicate 1 hour of time. The calls are scheduled and set up for the physician(s). Panel Hearing calls are typically scheduled at least 2 weeks in advance to provide the physicians with plenty of notice.
Panel Appeal Hearings are a component of the referral assignment from one of our clients. Dane Street and its clients...

This is a telework opportunity for supplemental income for physicians providing a caseload customized to your schedule. Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case basis.

Preferred candidates will hold Nevada Medical License (M.D., D.O.)

JOB SUMMARY

Physician Reviewer/Advisor utilizes clinical expertise to review, provide interpretation of clinical treatment guidelines and opine on the medical necessity of services/treatment proposed or 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 utilizing client-specific criteria or other nationally recognized evidence-based criteria
• Ensures a clear rationale for determination that is...

CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the company’s mission, actively engage in problem-solving, and take ownership of your work daily. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra seeks a Physician Reviewer MD/DO (CA Licensed Psychiatrist) - PRN to join our growing team.

Job Summary:

A Physician Reviewer who will provide principal leadership and clinical expertise to operations...

This 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.

Candidates must be an Orthopedic Surgeon in the Dallas or Houston area and hold a TX License, with testimony/deposition/counter affidavit work experience. Candidates must also have access to a TX notary or be readily available for online notaries.

JOB SUMMARY

Our Physician Reviewers need to have strong experience in analyzing the application of CPT codes in combination with usual and customary state fee schedule reductions across multiple jurisdictions with an in-depth understanding of CPT codes and the state-specific fees associated with them.

MAJOR DUTIES AND RESPONSIBILITIES:

• Reviews all medical records and...

Dane Street, a certified "Great Place to Work" company, is in search of a Board Certified Orthopaedic Spine Surgeon, Neurosurgeon, Neurologist, and Physical Medicine & Rehabilitation physician to process utilization reviews. Worker's Compensation experience is preferred but, not required. This telework opportunity provides the ability to customize your schedule and caseload within a standard Monday - Friday work 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 CA, GA, FL, IL, KY, LA, NV, or TX license.

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...

Dane Street, a certified "Great Place to Work" company, is in search of a Board Certified Oncologist, Interventional Radiologist, Pediatric Oncologist, Radiation Oncologist, Hematologist/Oncologist, and Medical Geneticist, physician to process Utilization Reviews / Group Health Appeals Reviews. This 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. Other preferred licenses are MN, IL, and CA.

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...

This 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 NY License, and be NY WC Board Certified.

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:

• 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...

This 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:

• 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...

This 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.

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:

• 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
...