Therapist
Talkiatry
Mid · Seniorfull-time$70k–$90k / yearKansas, Louisiana · 🇺🇸 United States
Posted: 1 day agoSource: jobs.lever.co
Board-Certified Neuropsychologist, Workers' Compensation IME
Dane Street
contract
Posted on:
Origin: • 🇺🇸 United States • New York
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Provide Physician Reviewer/Advisor services for Independent Medical Exams (IME) reviewing insurance appeals and prospective and retrospective claims
- Interpret medical necessity of services provided by other healthcare professionals in compliance with client-specific policies, evidence-based guidelines, and standards of care
- Review all medical records and address each client question using client-specific criteria or nationally recognized evidence-based criteria
- Ensure determinations include clear, concise rationale with adequate supporting documentation and provide copies of criteria used with reports
- Identify, critique, and utilize current guidelines and peer-reviewed literature to support objective decision-making
- Return cases on or before the due date and time and make required telephone calls
- Maintain credentials and state licenses, attend required training, and perform other duties as assigned (quality assurance, complaints, regulatory issues, depositions, court appearances, audits)
Requirements
- Board certification required
- Active practice required
- Maintain proper credentialing and state licenses and any special certifications or requirements necessary to perform the job
- Clinical expertise to review insurance appeals and prospective and retrospective claims
- Ability to review all medical records and address each question posed by the client utilizing client-specific or nationally recognized evidence-based criteria
- Ability to identify, critique, and utilize national, state, and professional association guidelines and peer-reviewed literature to support decision-making
- Must attend all required orientation and training
- Ability to make telephone calls as mandated by state and/or client specifics
- Ability to respond to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits
