About the job
Join our team as an IME Physician Panelist specializing in Physical Medicine, where you can tailor your work hours and case load while adhering to client-mandated turnaround times. As a 1099 independent contractor, you will be compensated on a per-case basis.
We are seeking qualified candidates who possess a valid Washington state license and are certified, or willing to become certified, by the Washington State Department of Labor and Industries (L&I).
Key Highlights:
- Conduct in-person exams in Bellevue, WA, with potential for additional locations in the future.
- Perform multiple examinations within a single day.
- Receive compensation for reasonable travel expenses incurred.
- Assistance provided by Dane Street for obtaining WA L&I certification.
- Video recording of approximately 15% of examinations may be required.
Job Summary:
Utilize your clinical expertise to review insurance appeals and both prospective and retrospective claims. The Physician Reviewer will assess the medical necessity of services rendered by other healthcare professionals in accordance with specific client policies, nationally recognized evidence-based guidelines, and established standards of care.
Major Responsibilities:
- Thoroughly review medical records while addressing each inquiry from clients using client-specific criteria or other recognized evidence-based criteria.
- Ensure clarity and conciseness in the rationale for determinations, supported by adequate documentation.
- Critically analyze and leverage current criteria and resources, including national, state, and professional association guidelines, to facilitate objective decision-making.
- Timely submission of copies of any criteria used in reviews.
- Return cases punctually and make necessary telephone calls as mandated by client specifications.
- Maintain proper licensing, credentialing, and any specific certifications required for the role.
- Attend all mandatory orientation and training sessions.
- Undertake additional duties as assigned, including responding to quality assurance issues and participating in audits or court appearances.
Important Note: For the safety and security of both parties, Dane Street will never conduct interviews via text or request candidates to purchase equipment with checks.