Physician Reviewer

About This Role

This role involves conducting Independent Medical Exams (IME) and Peer Reviews for various disability claims. You will utilize your clinical expertise to interpret the medical appropriateness of services, ensuring compliance with state regulations and evidence-based guidelines.

Responsibilities

• Review all medical records and address client questions using state-mandated or evidence-based criteria
• Ensure rationale for determinations is clear, concise, and adequately supported by documentation
• Return cases on or before the due date
• Maintain proper credentialing, state licenses, and necessary special certifications
• Attend all required orientation and training
• Identify, critique, and utilize current criteria and resources that support objective decision-making
• Provide copies of any criteria used in a review with the report in a timely manner
• Conduct Independent Medical Exams in a clean, safe, and professional manner

Requirements

• Board Certified in Internal Medicine, Family Practice, Physical Medicine & Rehabilitation, Occupational Medicine, Sports Medicine, or General Medicine
• Proper credentialing and state licenses