Orthopedic Advisor

Responsibilities

• Review medical records and address client questions using specific or evidence-based criteria
• Ensure determination rationales are clear, concise, and supported by documentation
• Utilize current national, state, and professional association guidelines and peer-reviewed literature
• Provide copies of utilized criteria with reports in a timely manner
• Return cases on or before the specified due date and time
• Perform telephone calls as mandated by state or client requirements
• Maintain proper credentialing, state licenses, and necessary certifications
• Respond to quality assurance issues, complaints, regulatory issues, depositions, or audits

Requirements

• Board certification in Orthopedics required
• M.D. or D.O. degree
• Active medical practice required
• Ability to perform Independent Medical Exams (IME)

Benefits

• Robust opportunity for supplemental income
• Schedule flexibility and predictable work hours
• Enhanced industry expertise in medical necessity and utilization review
• Expanded credentials as an expert in IME and physician advisor services
• Fully prepped cases and streamlined case flow
• Transcription services provided at no cost
• User-friendly work portal