Remote Physician Reviewer - Insurance Appeals & Guidelines
Dane Street
A healthcare review company is seeking a Physician Reviewer to work telecommuting. This role utilizes clinical expertise to review insurance appeals and claims. Candidates must possess an active NM License and have a solid understanding of evidence-based guidelines. Responsibilities include reviewing medical records, ensuring documentation quality, and maintaining licensure. This role offers a custom schedule as a 1099 independent contractor. #J-18808-Ljbffr
- Dane Street, LLC is looking for a physician reviewer to utilize clinical expertise in reviewing insurance appeals and claims for compliance with guidelines. This telework position allows for flexible scheduling while ensuring timely completion of work. Ideal candidates...Remote jobFlexible hours
- A telehealth review company is seeking a Physician Reviewer to evaluate insurance appeals and claims. This remote role requires candidates to hold licenses in NM, TX, MN, or NC. Responsibilities include reviewing medical records, ensuring compliance with client criteria...Remote workFlexible hours
- A healthcare services company is seeking a physician reviewer to utilize clinical expertise in reviewing insurance appeals and claims. This telework opportunity allows for a customizable schedule while ensuring compliance with client-specific policies. Candidates must hold...Remote workContract workFor contractors
- ...– Expert in Staffing APP’s and Physicians. The organization is a technology‑driven health insurance company built on a full‑stack platform... ..., and pharmacy services by reviewing clinical information and applying evidence‑based guidelines. Key Responsibilities Conduct timely...Remote workWeekend work
- ...Description Job Description Physician Peer Reviewer – Multiple Specialties in... ...Federal Hearings and Appeals Services (FHAS) is a URAC-accredited... ..., government agencies, insurance companies, and legal... ...reviews Job Type Contract Work Location Remote...Remote workContract workWork experience placementWork at office
- ...recognized Independent Review Organization (IRO), is... ...its panel of Physician Reviewers. We are currently... ...Reviews. This is a fully remote, non-clinical role... ...treatment requests and appeals. No patient contact, no... ...workers’ compensation guidelines and nationally...Remote workPrice workExtra incomeFor contractorsFlexible hours
- ...highly experienced DRG Clinical Physician Reviewer to join our growing clinical... ...team. This is a fully remote opportunity for a physician... ...plans using evidence-based guidelines Produce clear, concise clinical... ...reviews, including outlier and appeal cases Collaborate with...Remote work
- ...features. Location: Remote (Must reside in... ...board-certified physicians to join their Medicare... ...as Physician Reviewers. In this remote... ...apply evidence-based guidelines, and collaborate... ...Review Unit’s appeals process for service... ..., Term Life/AD&D Insurance, and a 401(k)...Remote workFull timeWeekend work
- Payfuture Technologies is hiring a Physician Reviewer specializing in Orthopedic Surgery. This remote role allows for flexibility while ensuring... ...case reviews based on established medical guidelines. You'll analyze insurance appeals and provide clear documentation to...Remote jobFor contractors
- ...is a leading Independent Review Organization (IRO) and... ...continue to expand our physician panel, we’re offering flexible, remote opportunities for board-... ...treatment requests and appeals, with no direct patient... ...and relevant treatment guidelines provided Peer‑to‑peer calls...Remote workExtra incomeFor contractorsFlexible hours
$211.2k - $277.2k
...we're Oscar. We're hiring a Physician Reviewer to join our Utilization... ...Oscar is the first health insurance company built around a full... ...and applying evidence-based guidelines. Hours: 8am - 5pm in your... ...Work Location: This is a remote position, open to candidates...Remote workFull timeLocal areaWork from homeHome officeWeekend work- ...mandated turnaround times. Our reviewers are compensated on a per-... ...TX, MN, and/or NC License. Physician Specialties: Radiation... ...clinical expertise and reviews insurance appeals, as well as prospective and... ...recognized evidence-based guidelines, and standards of care. MAJOR...Remote workFor contractors
- ...management organization is seeking experienced Physician Reviewers to join their Medicare Utilization Management team in a remote position. Responsibilities include reviewing... ...service requests, applying evidence-based guidelines, and collaborating to ensure quality care...Remote work
- ...A leading independent review organization is seeking a Utilization Management Physician Reviewer for a full-time remote role. Candidates must possess an active Nebraska medical... ...stakeholders, and ensuring compliance with medical guidelines. The role offers a structured schedule...Remote workFull timeCasual workMonday to Friday
- ...mandated turnaround times. Our reviewers are compensated on a per-case... ...expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation... ...recognized evidence-based guidelines, and standards of care. Major...Contract workFor contractors
- ...Can work remotely in any state except CA, NY, HI or AK 20 - 40 hours/week and possible weekend coverage (in a rotation)... ...evaluate clinical service requests. Participates in the Physician Review Units' appeal process of service denials. Participates in the development...Remote workWeekend work
- ...Board Certified Physicians Needed Dane Street, a certified "Great Place to Work'' company... ...Medical Exams (IME) and Peer Reviews. This opportunity allows you to customize... ...in compliance with state regulations and guidelines, nationally recognized evidence-based guidelines...Remote workFor contractorsMonday to Friday
- ...pay rate is ***/hour fully remote, but must reside in one of our plan states: IL, TX, NM... ...management for members whose cases come for review, in partnership with case managers. Participates in the Physician Review Units' appeal process of service denials. Participates...Remote workMonday to FridayShift workWeekend work
- ...turnaround times. Our reviewers are compensated on a per... .... Job Summary Our Physician Reviewers need to have... ...professional association guidelines and peer‑reviewed... ...stipend is provided for remote workspace. Come up to... ...process over 200,000 insurance claims annually for leading...Remote workFor contractorsWork experience placement
$90.87 - $154.33 per hour
...leading pharmacy benefit manager is seeking a remote Physician Clinical Reviewer specializing in Dermatology. This position... ..., providing clinical rationales for appeals, and ensuring compliance with established guidelines. This role offers potential pay ranging from...Remote work$90.87 - $154.33 per hour
...pharmacy benefit manager is seeking a Physician Clinical Reviewer - Dermatology to conduct medical... ...reviews and ensure adherence to clinical guidelines. This remote position requires an MD/DO with at... ...providing clinical rationale for appeals. Competitive pay ranges from $90.87...Remote work$174.07k - $374.92k
...Street Health Title: Full-Time Utilization Management Physician Reviewer Location: Remote/ Treehouse Role Description This full-time role is responsible... ...knowledge of current CMS and MCG evidence-based guidelines to enable UM decisions Maintain compliance with legal,...Remote workHourly payFull timeLocal area- ...Job Title External Physician Reviewer Job Type Occasional Category Medical Services... ...current liability and malpractice insurance coverage for non-UR clinical activities... ...territory of the United States when conducting appeal considerations Internet...Remote workFull timeContract workLocal areaWork from home
- Dane Street is an Independent Review Organization and a national... ...offerings) and we are expanding our physician panel resulting in... ...of treatment requests and, in appeals, the medical necessity of previously... ...as well as all treatment guidelines used to make a determination...Remote workExtra incomeContract work
$52k - $83k
CopperPoint Insurance Companies is seeking a fully remote Premium Audit Reviewer II. In this role, you will review and evaluate premium audits, ensuring their accuracy... ...a working knowledge of state-specific auditing guidelines. Candidates should have 2+ years in commercial...Remote job- ...Dane Street is an Independent Review Organization and a national... ...offerings). We are expanding our physician panel, resulting in... ...of treatment requests and, in appeals, the medical necessity of previously... ...records and treatment guidelines are provided in an easy, click...Remote workExtra incomeContract workFor contractors
- CopperPoint Insurance Companies is seeking a fully remote Premium Audit Reviewer II in New York. In this role, you will evaluate and review premium audits for accuracy... ...discrepancies and ensure compliance with guidelines. The ideal candidate should have strong analytical...Remote jobFlexible hours
$52k - $83k
CopperPoint Insurance Companies is looking for a Premium Audit Reviewer II to join our team remotely. The role involves reviewing premium audits, ensuring compliance with guidelines, and collaborating with internal teams. Ideal candidates have strong analytical skills and...Remote job$52k - $83k
CopperPoint Insurance Companies is seeking a fully remote Premium Audit Reviewer II in Pennsylvania. The role involves reviewing and evaluating premium audits for... ...teams and clients, and ensuring compliance with guidelines. Ideal candidates have strong analytical skills...Remote job- ...project documentation, coordinating with HOAs and insurance agents, and ensuring compliance with agency guidelines (Fannie Mae, Freddie Mac, FHA, VA). This role... ...internal teams and external stakeholders. Experience reviewing non-warrantable condo projects is essential. Key...Remote work
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