Internal Medicine-Independent Medical Examiner (IME)

Utilize clinical expertise to review insurance appeals, prospective and retrospective claims, and provide interpretations of medical necessity in compliance with client specific policies, nationally recognized evidence-based guidelines, and standards of care.

Requirements

• Reviews all medical records and addresses each question posed by the client
• Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation
• Identifies, critiques, and utilizes current criteria and resources to support sound and objective decision-making
• Provides copies of any criteria utilized in a review with the report
• Returns cases on or before the due date and time
• Makes telephone calls as mandated by the state and/or client specifics
• Maintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the job
• Attends all required orientation and training

Benefits

• Robust opportunity for supplemental income
• Schedule flexibility and predictable work hours
• Enhanced industry expertise
• Expanded credentials as an expert in Independent Medical Exams and physician advisor services
• Fully prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal