Key Facts

Remote From:

Canada, California (USA), Maryland (USA), United States

Freelance

Senior (5-10 years)

English

Hard Skills

Clinical Medicine Rheumatology Peer Review Utilization Management Peer-To-Peer Medical Licensing (Health Law) Medical Privacy Utilization Management Clinical Assessments Health Information Systems (HIS) +2 more

Other Skills

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Client Confidentiality
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Professionalism
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Communication

Roles & Responsibilities

Medical Degree (MD or DO)
Current, unencumbered medical license in Florida or Oregon
Board Certification in Rheumatology
At least 5 years of clinical experience (including residency)

Requirements:

Conduct independent utilization reviews for rheumatology cases
Perform peer and utilization reviews with accuracy and timeliness
Adhere to HIPAA regulations and MRIoA policies, ensuring confidentiality, privacy, and security of sensitive health information
Be available during daytime hours for peer-to-peer conversations

Medical Review Institute

About Medical Review Institute

Medical Review Institute of America, LLC (MRIoA) was incorporated in 1983. Today MRIoA is an industry leader in providing external review resources for over 800 clients nationwide. MRIoA provides review of medical, dental, behavioral health, pharmacy, vision, disability, workers' compensation, and auto claims for insurance carriers, employers, TPAs, self- administered union groups, pharmacy benefit managers, human resource consultants and departments of insurance throughout the country. MRIoA utilizes a nationwide network of board-certified physician specialists and professionals in over 133 specialties and sub-specialties of medicine. MRIoA also has reviewers in most states, offering the most extensive same-state reviewer resources available from an external review organization. MRIoA holds dual accreditation with URAC with certificates in Health Utilization Management and as an Independent Review Organization. In addition we are NCQA and SSAE 16 certified.MRIoA's goal is to render a professional, independent and unbiased opinion to assist our clients with their adjudication challenges or to provide an external source to comply with ERISA/DOL or state laws.MRIoA reviews cases prospectively, concurrently and retrospectively for: Medical Necessity, Appropriate Treatment, Experimental Procedures, Utilization Frequency, Appropriate Hospitalization, Formulary Criteria Review, Pre-Existing Conditions, Injury Causation, CPT Coding, Level of Disability, Provider Fees, Outpatient Facility Fees, and all Diagnostic Testing and Charges.MRIoA has provided state-level external review in many states since 2001. MRIoA is also contracted with hundreds of clients to offer Federal External Review under the ACA.

Company type: SME

Founded: 2018

Company size: 201 - 500

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Job description

Description

Flexible Independent Contractor (1099) Opportunity

Required State Medical License in Florida or Oregon

ABOUT MRIoA

Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally recognized Independent Review Organization (IRO) specializing in technology-driven utilization management and clinical medical review solutions. We’re a leader in Peer and Utilization Reviews, known for excellence and continuous improvement.

THE OPPORTUNITY:

We are currently seeking Board-Certified physicians in Rheumatology to conduct independent Utilization Reviews. This is a flexible, fully remote opportunity requiring just 1–2 hours per week—with no minimum commitment.

ADDITIONAL INFORMATION:

Work remotely from anywhere in the US (Per HIPPA Regulations patient records cannot leave the US).
Covered under MRIoA's Errors and Omissions policy.
Independent Contractor (1099) opportunity.
Workers are required to adhere to all applicable HIPAA regulations and company policies and procedures regarding the confidentiality, privacy, and security of sensitive health information.

California Consumer Privacy Act (CCPA) Information (California Residents Only):

Sensitive Personal Info: MRIoA may collect sensitive personal info such as real name, nickname or alias, postal address, telephone number, email address, Social Security number, signature, online identifier, Internet Protocol address, driver’s license number, or state identification card number, and passport number.
Data Access and Correction: Applicants can access their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at HR@mrioa.com.

Requirements

Must have a Medical Degree MD or DO
Must have a current STATE unencumbered medical license in Florida or Oregon
Current Board Certification in Rheumatology
Must have 5 years of clinical experience residency to be included
Daytime availability is required for peer-to-peer conversations