Provide telework-based utilization review and medical necessity reviews for urology cases, including appeals of previously denied services. Work is case-based and advisory only, with no patient treatment or doctor-patient relationship established.
Key Responsibilities
- Review medical necessity of treatment requests and appeal cases for urology services.
- Provide independent, advisory-only determinations based on submitted medical records and treatment guidelines.
- Participate in peer-to-peer calls when needed for adverse determinations.
- Use a web-based work portal to review organized case materials and supporting documentation.
- Complete reviews within assigned turnaround times and scheduled availability.
- Coordinate with administrative support teams that manage case flow, records, and communication.
Required
- Current, unrestricted Tennessee or Texas medical license.
- Board certification.
- Active clinical practice.
- Specialty training or experience in urology.
Preferred
- Prior utilization review or independent medical review experience.
- Experience with telework or asynchronous case-based review.
Benefits & Perks
- Schedule flexibility with case volume based on your availability.
- Independent 1099 contractor arrangement with per-case compensation.
- Training and onboarding completed in less than one week.
- Streamlined case flow with administrative support for records, communication, and reporting.
- Access to a user-friendly online portal with organized records and treatment guidelines.
- Ongoing support contact for questions about completing reviews.