D

Ophthalmology Physician

Dane Street

Worcester, MA
1 day ago
Up to $100/hour

Job Description

Join Dane Street as an Ophthalmology Physician Reviewer, where you will leverage your clinical expertise to evaluate insurance claims and ensure compliance with established guidelines. This flexible telework role allows you to manage your schedule while making a significant impact in the healthcare industry.

Key Responsibilities

  • Review insurance appeals and claims
  • Interpret medical necessity of services
  • Ensure clear and concise rationale for determinations
  • Utilize current criteria and resources for decision-making
  • Conduct Peer to Peer calls as needed
  • Maintain proper credentialing and licenses
  • Attend required orientation and training

Required Qualifications

  • Medical degree (MD or DO)
  • Current state medical license
  • Clinical expertise in ophthalmology

Preferred Qualifications

  • Experience in insurance appeals
  • Familiarity with evidence-based guidelines

Benefits & Perks

Flexible scheduleTelework opportunity