Orthopedic Surgeon, Telecommute Medical Review Stream Physician, MS License

Job not on LinkedIn

🔥 8 minutes ago

⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 15%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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 medical files • Provide medical interpretations and decisions regarding appropriateness of services • Provide recommendations for utilization review, chart reviews, medical necessity, appropriateness of care, return to work, short- and long-term disability, FMLA, group health, and workers’ compensation claims • Meet with the Concentra Physician Review Medical Director when required to discuss quality of care, credentialing, and state licensure issues • Maintain proper credentialing, state licenses, certifications, and other requirements • Return cases promptly with clear, concise, complete rationales and documented criteria • Contact providers by telephone and interact professionally with healthcare professionals • Explain disclaimers and appeal processes to providers • Attend orientation and training • Identify and respond to quality assurance issues, complaints, regulatory issues, depositions, court appearances, and audits • Identify, critique, and use current criteria and resources, including national, state, and professional association guidelines and peer-reviewed literature • Provide requested copies of review criteria to providers in a timely manner

🎯 Requirements

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

🏖️ Benefits

• Flexible schedule and caseload within a Monday–Friday work week and business hours • Compensation on a per-case basis as a 1099 independent contractor

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