Internal Medicine-Independent Medical Examiner (IME) jobs in United States
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Dane Street · 5 months ago

Internal Medicine-Independent Medical Examiner (IME)

Dane Street is seeking a Physician Reviewer/Advisor for Independent Medical Exams (IME) who will utilize clinical expertise to review insurance appeals and claims. The role involves interpreting the medical necessity of services provided by other healthcare professionals in compliance with guidelines and standards of care.

Auto InsuranceCommercial InsuranceEmployee BenefitsFinancial ServicesHealth InsuranceInsurance

Responsibilities

Reviews all medical records and addresses each question posed by the client utilizing client specific criteria or other nationally recognized evidence-based criteria
Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision
Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes
Provides copies of any criteria utilized in a review with the report in a timely manner
Returns cases on or before the due date and time
Makes telephone calls as mandated by the state and/or client specifics
Maintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the job
Attends all required orientation and training
Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits

Qualification

Board certificationClinical expertiseMedical necessity reviewInsurance appealsQuality assuranceCommunication skillsTime management

Required

Board certification required
Active practice required
Maintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the job
Attends all required orientation and training

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

Company

Dane Street

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Dane Street is an insurance company that offers review and evaluation services for workers compensation, health, and to some businesses.

Funding

Current Stage
Growth Stage

Leadership Team

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Josh Remillard
Chief Operating Officer
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Greg Powers
Chief Marketing Officer/SVP Sales
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Company data provided by crunchbase