Provide remote physician review for orthopedic surgery cases, evaluating medical records, CPT coding, and state fee schedule reductions to support client determinations. The work includes preparing clear, evidence-based rationales and responding to questions using client-specific or nationally recognized criteria. In addition to written reviews, the role may involve depositions, court appearances, audits, and other quality or regulatory follow-up as needed.
Key Responsibilities
- Review medical records and address each client question using client-specific or evidence-based criteria
- Analyze CPT code application and state-specific fee schedule reductions across multiple jurisdictions
- Prepare clear, concise review reports with supporting documentation and rationale
- Use national, state, and professional guidelines and peer-reviewed literature to support determinations
- Provide copies of criteria used in the review with the report in a timely manner
- Return cases by the required due date and time
- Maintain credentialing, state licensure, and any required special certifications
- Respond to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits
Required
- Orthopedic Surgeon
- Active Texas medical license
- Experience with testimony, depositions, or counter affidavit work
- Access to a Texas notary or availability for online notarization
Preferred
- Experience analyzing CPT codes and usual/customary fee schedule reductions
- Experience working across multiple jurisdictions
- Familiarity with insurance claims review or independent medical review processes
Benefits & Perks
- Remote telework schedule
- Ability to customize schedule and caseload within the week
- Per-case 1099 independent contractor compensation
- Paid time off
- Benefits package
- Competitive salary
- Apple equipment and media stipend for remote work
- Training program and orientation