State Licensed Orthopedic Reviewer

Job Summary

To support a national panel of independent clinical reviewers, the remote Independent Physician Reviewer - Orthopedic Surgery with Spine expertise will review medical necessity criteria, apply current standards of care, and render objective determinations on a per-case basis as an independent contractor.

Key responsibilities

• Review case files and apply medical necessity criteria while rendering objective determinations
• Cite supporting guidelines and literature, drafting clear rationales and communicating determinations within defined timelines
• Collaborate with the team to provide feedback aimed at improving the reviewer experience

Required qualifications

• Board Certified (ABMS or AOA)
• Five years of post-training experience with direct patient care in the last 12 months
• Active medical license, preferably multi-state
• Strong research and writing skills, with comfort in evidence-based decision-making
• Reliable home office setup and familiarity with independent contracting (1099)