Provide telework-based utilization review and medical necessity determinations for urology cases, including initial treatment requests and appeals of previously denied services. Reviews are advisory only and do not involve patient care, treatment, or a doctor-patient relationship. Work is case-based and can be scheduled around your availability, with independent contract review assignments.
Key Responsibilities
- Conduct medical necessity reviews for urology treatment requests and appeal cases.
- Provide advisory-only determinations based on medical records and treatment guidelines.
- Review cases through a streamlined online work portal with organized documentation.
- Coordinate, when needed, peer-to-peer calls for adverse determinations.
- Use provided chronological medical record summaries and treatment guidelines to support review decisions.
- Participate in telework assignments with case volume set by your scheduled availability.
Required
- Current, unrestricted Louisiana medical license.
- Board certification.
- Active clinical practice.
- Specialty training or practice in urology.
Benefits & Perks
- Independent contractor 1099 role with per-case compensation.
- Schedule flexibility with predictable work hours.
- Telework format with customized caseload.
- Initial training and onboarding completed in less than one week.
- Ongoing support contact for review questions.
- Administrative support for record sorting, communication, and report delivery.
- User-friendly portal with easy access to records and guidelines.