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Board Certified Hematology Physician Advisor, Disability Peer Review

Remote: 
Full Remote
Contract: 
Work from: 

Offer summary

Qualifications:

Board Certified in Hematology with an active medical license is mandatory., Strong understanding of medical necessity and utilization review/management., Ability to utilize current medical guidelines and evidence-based resources., Experience in reviewing medical records and providing expert opinions..

Key responsabilities:

  • Review and assess medical records related to Hematology for client queries.
  • Document determinations clearly and concisely with supporting evidence.
  • Provide timely reports and adhere to deadlines for case completion.
  • Participate in quality assurance and mandatory training programs.

Dane Street, LLC logo
Dane Street, LLC Insurance SME https://www.danestreet.com/
51 - 200 Employees
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Job description

Dane Street is expanding our physician panel!  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.

The ideal candidate will be Board Certified in Hematology with an active medical license.

Requirements

JOB SUMMARY

As a Physician Advisor for Disability Peer Review, your specialization in Hematology will be utilized to review cases and provide expert opinions on the medical necessity of treatments and claims. The Physician Reviewer will ensure that all reviews comply with client-specific policies and adhere to nationally recognized standards of care.

MAJOR DUTIES AND RESPONSIBILITIES:

    • Thoroughly review and assess medical records related to Hematology to address client queries using appropriate criteria and guidelines.
    • Ensure the clarity and conciseness of determinations through well-supported documentation.
    • Utilize current medical guidelines, evidence-based resources, and peer-reviewed literature to support sound decision-making.
    • Provide timely reports along with any relevant criteria used in the review.
    • Adhere to specified deadlines for case completion and submission.
    • Conduct follow-up communication as required based on individual case needs.
    • Maintain necessary licensure and certifications to perform the required duties effectively.
    • Participate in mandatory training and orientation programs.
    • Handle quality assurance matters and participate in audits or other reviews as necessary.
  • Board certification in Hematology and active practice are mandatory for this role.

PLEASE NOTE: In the interest of maintaining the security of all involved parties, Dane Street never conducts interviews through text or requests checks from applicants for any purpose, including equipment purchases. 

Benefits

  • Robust opportunity for supplemental income
  • Schedule flexibility and predictable work hours - You choose services and case types, dictate volume, and conduct exams and reviews based on your schedule availability
  • No doctor/patient relationship is established and no treatment is provided. These are advisory-only opinions.
  • Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management expertise
  • Expanded credentials as an expert in Independent Medical Exams and physician advisor services
  • Fully prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal

Dane Street supports all referral processes, scheduling, preps cases extensively, prepares all medical records, provides transcription services as applicable, facilitates all client communications, and ensures the quality and timeliness of all reports and report delivery.  

Required profile

Experience

Industry :
Insurance
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Decision Making
  • Time Management
  • Detail Oriented
  • Communication

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