Texas Licensed Medical Reviewer

A company is looking for a Board Certified Surgeon for a telecommute medical review position. Key Responsibilities Review medical files and provide recommendations for utilization review and medical necessity Meet with the Medical Director to discuss quality of care and credentialing issues Maintain proper credentialing and respond to quality assurance issues and audits Required Qualifications, Training, and Education Board certified MD or DO with an understanding of managed care and utilization of services Current, unrestricted clinical license(s) or a process to ensure compliance with restrictions Board certification by the American Board of Medical Specialties or American Board of Osteopathic Specialties Active medical practice required for performing appeals Post-graduate experience in direct patient care

Mar 26, 2025 - 00:47

A company is looking for a Board Certified Surgeon for a telecommute medical review position. Key Responsibilities Review medical files and provide recommendations for utilization review and medical necessity Meet with the Medical Director to discuss quality of care and credentialing issues Maintain proper credentialing and respond to quality assurance issues and audits Required Qualifications, Training, and Education Board certified MD or DO with an understanding of managed care and utilization of services Current, unrestricted clinical license(s) or a process to ensure compliance with restrictions Board certification by the American Board of Medical Specialties or American Board of Osteopathic Specialties Active medical practice required for performing appeals Post-graduate experience in direct patient care