This role focuses on telework-based independent medical exams and advisory review work for orthopedic surgery cases, with a caseload that can be tailored to the clinician’s schedule. The physician reviews insurance appeals and prospective or retrospective claims, evaluating medical necessity and producing evidence-based determinations. Work is advisory only and does not involve treatment or an established doctor-patient relationship.
Key Responsibilities
- Review medical records and answer client-specific questions using approved criteria and evidence-based guidelines
- Assess the medical necessity of services provided by other clinicians
- Prepare clear, concise reports with supporting documentation and cited rationale
- Use national, state, and professional association guidelines and peer-reviewed literature to support determinations
- Return completed cases by the required due date and time
- Make telephone calls when required by state or client-specific rules
- Participate in orientation, training, quality assurance, and audit-related activities as needed
- Maintain active credentialing, state licensure, and any required special certifications
Required
- MD or DO degree
- Board certification in Orthopedic Surgery
- Active New York medical license
- Active clinical practice
- Experience completing Independent Medical Exams
Preferred
- New York State Workers' Comp certification
Benefits & Perks
- 1099 independent contractor arrangement
- Per-case compensation
- Telework opportunity
- Flexible schedule with customizable case volume
- No treatment provided and no doctor-patient relationship established
- Fully prepared cases and streamlined case flow
- Transcription services provided at no cost
- User-friendly work portal
- Support with scheduling, case preparation, client communications, report quality, and report delivery