Licensed Physician Reviewer, Multiple Specialties

Dane Street

Physician Reviewers (M.D., D.O.) reviewing insurance appeals and claims compliance with client policies. Requires active NM license and offers flexible scheduling for independent contractors.

Posted 7/29/2026contractRemote • New Mexico • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates clinical expertise in reviewing insurance appeals and claims, ensuring clear and concise rationale supported by evidence-based criteria. Maintains active NM License and adheres to regulatory requirements while addressing quality assurance issues and client-specific needs.

Highest-signal resume keywords

Clinical ExpertiseInsurance Appeals ReviewEvidence-Based CriteriaActive NM LicenseQuality Assurance

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Claims ReviewMedical Record ReviewDocumentation SupportDecision-MakingRegulatory Compliance

Soft Skills

CommunicationAttention to DetailTimeliness

Industry Keywords

National GuidelinesState GuidelinesProfessional Association GuidelinesPeer-Reviewed LiteratureCredentialing

About the role

Key responsibilities & impact

Utilizes clinical expertise, reviews insurance appeals, and prospective and retrospective claims
Reviews all medical records and addresses each question posed by the client utilizing client-specific criteria or other nationally recognized evidence-based criteria
Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision
Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes
Provides copies of any criteria utilized in a review with the report in a timely manner
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
Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits

Requirements

What you’ll need

Candidates must hold an active NM License

Benefits

Comp & perks

🌐 Worldwide ❌ Jobs You've Hidden ⭐️ Saved Jobs ✅ Applied Jobs ✉️ Email Alerts 👤 Account Dane Street Website LinkedIn All Job Openings 51 - 200 employees 🏥 Healthcare 💼 Consulting ⚖️ Legal Healthcare
Consulting
Legal Dane Street is a national leader in Independent Medical Exams and Reviews, providing objective, compliant, and timely Independent Medical Examinations, Peer Reviews, and other medical reports. With a large network of over 16,000 physicians, the company offers its services across 25,000 locations and 100 specialties, including Workers' Compensation, Auto, Liability, and Disability claims. Dane Street supports Insurance Carriers, Third Party Administrators, Managed Care Organizations, and Federal/State entities with expert medical analyses, helping them make accurate determinations. The company is recognized for its quality, fast turnaround times, and efficient processes, earning accolades like the NCQA Accreditation in Utilization Management and the Great Place to Work certification. Licensed Physician Reviewer, Multiple Specialties 🔥 5 minutes ago 🌶️ New Mexico – Remote ⏳ Contract/Temporary 🟡 Mid-level 🟠 Senior Apply Now Find Hiring Managers Customize resume + cover letter Report problem ☆ Save ☑️ Mark as applied ❌ Hide 📋 Description
Utilizes clinical expertise, reviews insurance appeals, and prospective and retrospective claims
Reviews all medical records and addresses each question posed by the client utilizing client-specific criteria or other nationally recognized evidence-based criteria
Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision
Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes
Provides copies of any criteria utilized in a review with the report in a timely manner
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
Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits 🎯 Requirements
Candidates must hold an active NM License Apply Now 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score Similar Jobs Virtual Weight Management MD/DO 🔥 5 minutes ago Enara Health 51 - 200 🏥 Healthcare 🍽️ Food & Beverage ⚕️ Healthcare Insurance Website LinkedIn All Job Openings Virtual Weight Management MD/DO providing synchronous and asynchronous telehealth care for diverse patients. Leading a multidisciplinary team within a tech-based private practice specializing in obesity medicine. 🇺🇸 United States – Remote 💵 $100 - $135 / hour 💰 $6M Seed Round on 2022-06 ⏳ Contract/Temporary 🟡 Mid-level 🟠 Senior Functional Medicine Practitioner – MD/DO or NP Contractor 🔥 13 minutes ago Everly Health 501 - 1000 🏥 Healthcare 🍽️ Food & Beverage 📦 Logistics Website LinkedIn All Job Openings Functional Medicine Practitioner providing telehealth consultations and personalized care plans for a digital health company. Utilizing clinical expertise to deliver actionable health insights and support patient education. 🇺🇸 United States – Remote ⏳ Contract/Temporary 🟢 Junior 🟡 Mid-level Contract Physician – Medical Necessity Review, Genetic Testing 🔥 13 minutes ago Everly Health 501 - 1000 🏥 Healthcare 🍽️ Food & Beverage 📦 Logistics Website LinkedIn All Job Openings Physician reviewing clinical documentation to determine medical necessity for genetic testing in a remote telehealth setting. Contributing to compliance and documentation standards for federal payers. 🇺🇸 United States – Remote ⏳ Contract/Temporary 🟡 Mid-level 🟠 Senior Virtual Physician – 1099 Contractor 🔥 14 minutes ago Ro 201 - 500 💼 Consulting 🏥 Healthcare ⚕️ Healthcare Insurance Website LinkedIn All Job Openings Telemedicine Physician role focused on patient care through Ro’s telehealth platform. Seeking physicians with a blend of competence and compassion for diverse healthcare needs. 🇺🇸 United States – Remote ⏳ Contract/Temporary 🟢 Junior 🟡 Mid-level 🦅 H1B Visa Sponsor Telehealth Physician – Weight Management, MD/DO 🔥 17 minutes ago Berry Street 1001 - 5000 🤝 Non-profit 📚 Education 🌍 Social Impact Website LinkedIn All Job Openings Telehealth Physician delivering weight management care through clinical evaluations and GLP-1 prescribing. Working remotely as part of a collaborative healthcare team in an innovative nutrition therapy company. 🇺🇸 United States – Remote ⏳ Contract/Temporary 🟡 Mid-level 🟠 Senior 🌐 Worldwide Built by Lior Neu-ner. I'd love to hear your feedback — Get in touch via DM or support@remoterocketship.com Search Search Jobs by country Search jobs by city Search jobs by job title Search entry-level jobs Search junior-level jobs Search senior-level jobs Search jobs by tech stack Search jobs by contract type Search remote internships Search remote part-time jobs Remote jobs Anywhere in the World Companies Hiring Anywhere in the World Companies Hiring Sales People Anywhere in the World Companies Hiring Software Engineers Anywhere in the World Resources Advice Tips for finding remote jobs Interview questions and answers Resume examples Cover letter examples Post a job Affiliates Is Remote Rocketship legit? Privacy policy Terms of service Job board SEO course Remote Job Search MasterClass AI Apply Copilot OpenClaw job finder Find jobs using your resume Jobs by Country Remote jobs anywhere in the world (Worldwide remote jobs) Remote jobs United States Remote jobs Australia Remote jobs Brazil Remote jobs Canada Remote jobs France Remote jobs Ireland Remote jobs Germany Remote jobs Netherlands Remote jobs Spain Remote jobs UK Popular Jobs Remote data analyst jobs Remote customer support jobs Remote executive assistant jobs Remote marketing jobs Remote product designer jobs Remote product manager jobs Remote project manager jobs Remote recruiter jobs Remote sales jobs Remote software engineer jobs Jobs by Type Remote full-time jobs Remote part-time jobs Remote contract jobs Remote internship jobs Remote entry-level jobs Remote jobs with no experience required Remote junior jobs (1-3 years of experience) Digital nomad jobs Remote jobs with no degree required Freelance remote jobs Temporary remote jobs Remote jobs hiring now Stay at home mom jobs