Physician Clinical Reviewer-RBM

Job Summary

A company is looking for a Physician Clinical Reviewer-RBM.

Key Responsibilities:

• Serve as the Clinical Reviewer in Imaging cases that do not meet medical necessity guidelines
• Discuss determinations with requesting physicians within regulatory timeframes
• Provide clinical rationale for standard and expedited appeals

Required Qualifications:

• MD/DO/MBBS degree
• Minimum of five years' post-residency experience in Medicine
• Current, unrestricted clinical license and active Board Certification
• Obtaining and maintaining medical licenses in the state of residence
• Strong clinical, management, and organizational skills