Orthopedic Surgeon – Telecommute Medical Review Stream Physician

🔥 1 hour ago

🏄 California – Remote

🏄 California – Remote

💵 $30 - $90 / hour

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Concentra

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

🧬 Biotechnology

Healthcare • Healthcare Insurance • Biotechnology

Concentra is a leading provider of healthcare services, focusing on rehabilitation and recovery for patients with critical illnesses and injuries. With an extensive network of inpatient rehabilitation hospitals and outpatient centers across the United States, Concentra is committed to delivering exceptional patient care that promotes healing and quality of life. Their team of over 45,000 healthcare professionals works collaboratively to design personalized treatment plans aimed at restoring function and facilitating a smooth transition from hospital to home.

📋 Description

• Review health claims and provide medical interpretation and decisions on the appropriateness of services • Review medical files and provide recommendations for utilization review, chart reviews, medical necessity, appropriateness of care, return to work, disability, FMLA, group health, and workers’ compensation claims • Meet with the Concentra Physician Review Medical Director regarding quality of care, credentialing, and state licensure issues • Maintain proper credentialing, state licenses, certifications, and other job requirements • Return cases promptly with clear, complete rationales and documented criteria • Contact providers by telephone and discuss disclaimers and appeal processes • Attend orientation and training • Identify and respond to quality assurance, complaint, regulatory, deposition, court appearance, and audit matters • Identify, critique, and use current criteria, guidelines, and peer-reviewed literature in reviews • Provide requested review criteria copies to providers promptly

🎯 Requirements

• Board certified MD or DO • Current, unrestricted clinical license(s); candidates must have a California license • Board certification by the American Board of Medical Specialties or American Board of Osteopathic Specialties required for MD or DO reviewer • Must be in active medical practice to perform appeals • Post-graduate experience in direct patient care • Understanding of network services, managed care, utilization of services, credentialing, quality assurance, and policy development • Demonstrated computer and telephonic skills • Demonstrated ability to perform review services • Ability to work with regulatory agencies, carriers, employers, nurses, and health care professionals • No financial conflict of interest • Current errors and omissions liability coverage • Managed care orientation • Knowledge of current practice standards in specialty • Good negotiation and communication skills • Phone access and computer access to complete reviews • Ability to complete cases with typed reports within specified time frames • Ability to participate in telephonic conferences • Ongoing discretion and secure management of confidential and sensitive information

🏖️ Benefits

• Flexible schedule and caseload within a Monday–Friday work week and business hours • Work/life balance • Telecommute work arrangement • Compensation on a per-case basis as a 1099 independent contractor • Orientation and training • Growth and well-being support • Equal opportunity employment

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