Virginia Licensed Cardiologist Reviewer

A company is looking for a Cardiologist - Physician Clinical Reviewer. Key Responsibilities Serve as the specialty match reviewer in Cardiology cases that do not initially meet medical necessity guidelines Provide clinical rationale for standard and expedited appeals Discuss determinations with requesting physicians or ordering providers within the regulatory timeframe Required Qualifications, Training, and Education MD/DO/MBBS - Required Current, unrestricted clinical license in medicine or required specialty - Required Active Board Certification in Cardiology, Vascular Surgery, or Adult Congenital Heart Disease - Required Minimum of five (5) years' experience in the practice of Cardiology - Preferred Computer Proficiency - Required

Mar 28, 2025 - 01:02

A company is looking for a Cardiologist - Physician Clinical Reviewer. Key Responsibilities Serve as the specialty match reviewer in Cardiology cases that do not initially meet medical necessity guidelines Provide clinical rationale for standard and expedited appeals Discuss determinations with requesting physicians or ordering providers within the regulatory timeframe Required Qualifications, Training, and Education MD/DO/MBBS - Required Current, unrestricted clinical license in medicine or required specialty - Required Active Board Certification in Cardiology, Vascular Surgery, or Adult Congenital Heart Disease - Required Minimum of five (5) years' experience in the practice of Cardiology - Preferred Computer Proficiency - Required