Florida Licensed Medical Consultant

Job Summary

A company is looking for a Doctor of Medicine - Consultant.

Key Responsibilities

• Provide medical information to guide insurance coverage determinations in claims reviews
• Conduct primary and secondary-level medical reviews to validate initial findings
• Utilize knowledge of Medicare and Medicaid programs to evaluate claims

Qualifications

• Board-certified physician (MD or DO) in an ABMS-recognized specialty
• Minimum of 3 years of experience in the health insurance industry
• Actively practicing and licensed in the state of residence
• In-state and like-licensed (must match the jurisdiction of practice)
• Proficient in both spoken and written Spanish