Conduct independent medical exams and physician review work focused on orthopedic surgery, insurance appeals, and prospective and retrospective claims. This telework role centers on evaluating medical necessity, reviewing records, and providing advisory-only opinions rather than treatment. It is a flexible, per-case contract arrangement with cases supported by a structured review process and transcription services.
Key Responsibilities
- Review medical records and answer client-specific questions using evidence-based criteria and standards of care.
- Provide clear, concise rationales supported by documentation, guidelines, and peer-reviewed literature.
- Conduct telephone calls when required by state or client policy.
- Return cases by the assigned due date and maintain timely report completion.
- Identify and respond to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits as assigned.
- Attend required orientation and training and maintain active licensure and required certifications.
Required
- MD or DO degree.
- Board certification in Orthopedic Surgery.
- Active New York medical license.
- Active practice required.
- Experience completing Independent Medical Exams.
- New York State Workers' Compensation certification preferred by the employer as an ideal qualification.
Preferred
- Based in Erie County, NY.
- New York State Workers' Compensation certification.
- Experience with utilization review or medical necessity review.
Benefits & Perks
- Telework arrangement with schedule flexibility.
- Supplemental income paid on a per-case basis.
- Ability to choose services, case types, and case volume based on availability.
- Fully prepped cases and streamlined case flow.
- Transcription services provided at no cost.
- User-friendly work portal and support for referrals, scheduling, and client communications.
- No doctor/patient relationship and no treatment responsibilities.
- Opportunity to build expertise in medical necessity, utilization review, and IME physician advisor work.