Surgeon Medical Director

Job Summary

A company is looking for a Medical Claims Review Medical Director - Surgeon - Remote.

Key Responsibilities

• Conduct coverage reviews and render coverage determinations based on member plan benefits
• Document clinical review findings in accordance with policies and regulatory requirements
• Engage with providers in peer-to-peer discussions and collaborate on benefit determinations

Required Qualifications

• M.D. or D.O. with an active unrestricted medical license
• Board certification as a Surgeon
• 5+ years of clinical practice experience post-residency
• Sound understanding of Evidence Based Medicine (EBM)
• Proficiency in MS Word, Outlook, and Excel