Physicians perform independent medical exams and peer reviews for disability claims, using medical records and evidence-based criteria to assess the appropriateness of services provided by other clinicians. The work is case-based and includes completing clear written rationales, with some in-person exam duties in a professional setting. This is a 1099 independent contractor role with a schedule and caseload that can be customized within a standard Monday through Friday workweek.
Key Responsibilities
- Review medical records and answer client questions using state-mandated or nationally recognized evidence-based criteria.
- Provide clear, concise rationales with supporting documentation for review determinations.
- Conduct independent medical exams in a clean, safe, professional setting.
- Return completed cases by the required due date and time.
- Use current national, state, and professional association guidelines and peer-reviewed literature to support objective decision-making.
- Provide copies of criteria used in the review with the report in a timely manner.
- Identify and respond to quality assurance, complaint, regulatory, deposition, court appearance, or audit issues as needed.
Required
- Board certification in Internal Medicine, Family Practice, Physical Medicine & Rehabilitation, Occupational Medicine, Sports Medicine, or General Medicine.
- Current state licensure and any required special certifications to perform the work.
- Ability to complete orientation and training as required.
- Experience interpreting clinical documentation and applying evidence-based criteria.
Preferred
- Experience with independent medical exams or peer review work.
- Familiarity with disability claims review, utilization review, or medical necessity determinations.
- Experience working with URAC-related guidelines or similar review standards.
Benefits & Perks
- Customizable schedule and caseload within a standard Monday through Friday workweek.
- Per-case compensation as a 1099 independent contractor.
- Case assignments are coordinated based on your jurisdiction or area.