New Jersey Licensed Family Practice Reviewer

A company is looking for a Family Practice Telecommute Medical Reviewer. Key Responsibilities Reviews medical files for utilization review, medical necessity, and appropriateness of care Maintains proper credentialing, state licenses, and certifications necessary for the role Interacts with healthcare professionals and discusses the appeal process and quality of care issues Required Qualifications Board certified MD or DO with a strong understanding of managed care and utilization of services Current, unrestricted clinical license(s) Board certification by relevant medical specialties is required Active participation in medical practice is necessary for performing appeals Post-graduate experience in direct patient care

Mar 12, 2025 - 01:35

A company is looking for a Family Practice Telecommute Medical Reviewer. Key Responsibilities Reviews medical files for utilization review, medical necessity, and appropriateness of care Maintains proper credentialing, state licenses, and certifications necessary for the role Interacts with healthcare professionals and discusses the appeal process and quality of care issues Required Qualifications Board certified MD or DO with a strong understanding of managed care and utilization of services Current, unrestricted clinical license(s) Board certification by relevant medical specialties is required Active participation in medical practice is necessary for performing appeals Post-graduate experience in direct patient care