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Board Certified Medical Toxicology Physician Advisor, Disability Peer Review

Remote: 
Full Remote
Contract: 
Work from: 

Offer summary

Qualifications:

Board Certified in Medical Toxicology, Active medical license required, Expertise in medical necessity and utilization review, Familiarity with clinical guidelines and peer-reviewed literature.

Key responsabilities:

  • Review and evaluate medical records related to toxicity and adverse effects of substances
  • Provide clear and concise determinations supported by documentation
  • Deliver timely reports and maintain compliance with client-specific policies
  • Participate in quality assurance and audits as needed.

Dane Street, LLC logo
Dane Street, LLC Insurance SME https://www.danestreet.com/
51 - 200 Employees
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Job description

Dane Street is expanding our physician panel!  This is a telework opportunity for supplemental income for physicians providing a caseload customized to your schedule. Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case basis.

Candidates must be Board Certified in Medical Toxicology, with an active medical license.

Requirements

JOB SUMMARY

As a Physician Advisor for Disability Peer Review, you will utilize your expertise in medical toxicology to review cases and provide insights on the medical necessity of treatments and claims. The Physician Reviewer will ensure compliance with client-specific policies and nationally recognized standards of care.

MAJOR DUTIES AND RESPONSIBILITIES:

    • Reviews and evaluates medical records related to toxicity and adverse effects of substances to address each question posed by the client using relevant criteria and standards.
    • Ensures that determinations made are clear, concise, and supported by adequate documentation.
    • Identifies and utilizes current clinical guidelines, evidence-based resources, and peer-reviewed literature to ensure objective decision-making.
    • Provides timely reports along with any criteria utilized in the review.
    • Returns cases by the specified due date and time.
    • Performs follow-up calls as needed based on specific case requirements.
    • Maintains proper licensure and certification, ensuring that all requirements necessary to perform the job are met.
    • Participates in required orientations and training sessions.
    • Addresses any quality assurance issues and participates in audits or additional required reviews as needed.
  • Board certification in Medical Toxicology and active practice required.

PLEASE BE AWARE: In the interest of the security of all parties, Dane Street will never conduct interviews via text or request checks from candidates for any reason including the purchase of equipment. 

Benefits

  • Robust opportunity for supplemental income
  • Schedule flexibility and predictable work hours - You choose services and case types, dictate volume, and conduct exams and reviews based on your schedule availability
  • No doctor/patient relationship is established and no treatment is provided. These are advisory-only opinions.
  • Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management expertise
  • Expanded credentials as an expert in Independent Medical Exams and physician advisor services
  • Fully prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal

Dane Street supports all referral processes, scheduling, preps cases extensively, prepares all medical records, provides transcription services as applicable, facilitates all client communications, and ensures the quality and timeliness of all reports and report delivery.  

Required profile

Experience

Industry :
Insurance
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Decision Making
  • Quality Assurance
  • Time Management
  • Communication

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