Board-certified rheumatology physician to review independent medical exams (IMEs), insurance appeals, and prospective/retrospective claims, assessing medical necessity and adherence to evidence-based guidelines and client policies. Responsible for interpreting services provided by other healthcare professionals and providing clinical opinions in line with standards of care. Serves as a physician reviewer/advisor to support utilization review, appeals adjudication, and medico-legal determinations.
As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client specific policies, nationally recognized evidence-based guidelines, and standards of care.
rheumatology, medical review, independent medical exam, insurance appeals, utilization review, medical necessity, claims review, evidence-based guidelines, clinical consultation
...Opportunities Fun and Energetic Environment Discount on Products and Services Job Summary We are seeking a talented Color Specialist to join our team, providing customers with flawless haircuts and hairstyles and helping them to look their best! As a Colorist...
...projects while meeting tight deadlines Qualifications Required Bachelor's degree in Marketing, English, Communications, Journalism, or related field Minimum of 4 years of copywriting experience, ideally in book publishing or media Proficiency in the...
...operate the GPU supercomputing environment that powers largescale training and inference. You will deliver highperformant, reliable, and... ...(Kubernetes, Slurm, or similar) for topologyaware placement, preemption, quotas, and fairshare multitenancy. Monitor...
...401k with matching Escalating vacation time Referral bonuses Tuition reimbursement Professional development training Free beverages and snacks Weekly catered lunches and breakfast on Fridays Grow to be our next leader: At RGi, fostering...
...Tunneling Survey Party Chief The Tunneling Survey Party Chief is responsible for providing precise surveying support for tunneling projects, including monitoring tunnel alignment, controlling excavation progress, and ensuring compliance with design specifications....