Job Summary

A staffing agency has a current position open for a Telecommute Utilization Review Orthopedic Surgeon.

Core Responsibilities of this position include:

• Reviewing appeals for denied services related to current relevant medical experience
• Discussing with referring physicians to clarify clinical information and explain review outcome decisions
• Documenting all actions related to clinical review sessions

Qualifications Include:

• Active unrestricted license to practice medicine as a utilization review MD or DO
• Familiarity with automated processes and computer applications and systems
• 5+ years of clinical practice experience
• Knowledge of applicable state and federal laws, URAC and NCQA standards
• Must be board certified through the ABMS