Dane Street is seeking a Child/Adolescent Physician to review insurance appeals and claims in a telework capacity. The role allows for customization of schedule and caseload while ensuring timely delivery of client-mandated turnaround times.
Key responsibilities
Utilize clinical expertise to interpret medical necessity of services
Review insurance appeals and prospective/retrospective claims
Provide clear and concise rationale for determinations with supporting documentation
Critique and utilize current criteria and resources for decision-making
Participate in Peer to Peer calls as required
Return cases on or before due date and time
Maintain proper credentialing, state licenses, and certifications
Attend required orientation and training
Respond to quality assurance issues or audits
Required skills
Child Psychiatry
Adolescent Psychiatry
Telemedicine
Healthcare Compliance
Insurance Appeals
Clinical Review
Quality Assurance
Medical Necessity Review
What the company offers
Compensated on a per-case basis as a 1099 independent contractor
Dane Street provides medical review services, focusing on healthcare compliance, appeals, and quality assurance. They engage contractors to perform clinical reviews on a flexible schedule while adhering to specific client guidelines. Read More
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