Physician Reviewer/Advisor For Independent Medical Exams (Ime)As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews insurance appeals, and 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 criteriaEnsures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decisionIdentifies, 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 sizesProvides copies of any criteria utilized in a review with the report promptlyReturns cases on or before the due date and timeMakes telephone calls as mandated by the state and/or client specificsMaintains proper credentialing, state licenses, and any special certifications or requirements necessary to perform the jobPerforms other duties as assigned, including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or auditsBoard certification required, active practice requiredPlease be aware that, in the interest of all parties, Dane Street won't conduct interviews via text or request checks from candidates for any reason, including the purchase of equipment.
About the Role:The Web Development Manager manages and coordinates the activities of web development staff who perform technical systems... ..., enterprise architecture, and web development technologies.Optimize multiple branded websites to generate leadsMonitor project progress...
...environment that fosters innovation and collaboration. As a Senior Technical Recruiter, you will collaborate closely with our hiring teams to spot, attract, and hire top talent, playing a pivotal role in shaping the future of our growing organization. What you'll do:...
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...inpatient and outpatient healthcare in 40 specialties. LRH has achieved multiple workplace awards from highly reputable names including Aetna, Forbes and the Florida Hospital Association. Our 910-bed main campus operates a Level I Trauma Center, a Level III Neonatal...
...Job Description: @VOTEis looking for a Greek Life Strategic Specialist to drive voter outreach and engagement within the sorority and fraternity communities nationwide. This role will focus on building meaningful relationships with Greek Life chapters to increase their...