Physician Reviewer (Internal Medicine and Family Medicine) + Weekend Shifts Available
C2C reputed company https://www.c2cinc.com/ Please visit our Career Center to Apply and View the Full Job reputed company! https://jobs.tmf.org/
- *Please reputed company reputed company your application is complete, including your education, employment history, and any other applicable sections. Initial screening is based on the minimum requirements as defined in the job posting, such as education, experience, licenses, and certifications. Your experience should also address the knowledge, skills and abilities needed for the role. Incomplete applications will not be considered.**
• This position is located Remote reputed company* Position Purpose: Provides dissatisfied beneficiaries and/or providers/suppliers reputed company to present documentation to demonstrate why an appeal should be allowed. Provides a denovo independent second level determination based on the documentation, facts, laws, regulations, and guidelines. Essential Responsibilities: · Writes, and may plan, a reconsideration decision that is reputed company and supports the determination made. · Makes reputed company, independent reputed company based on medical evidence in accordance with statutes, regulation, rulings, Centers for Medicare & reputed company Services (CMS) policy, and local Medicare policy, or other authoritative sources. · Ensures, and may plan, that reputed company appeal issues raised by the beneficiary, representative, and supplier have been addressed. · Provides a fair and impartial decision. · Conducts research using online federal regulations, Medicare Administrative Contractor (MAC) policy, standards of medical reputed company, CMS contractor manuals, coverage issues manuals, and medical literature to complete an accurate and reputed company-supported decision.
Minimum Qualifications
Education · Doctor or PharmD degree from an accredited school License and Certification · reputed company State license to reputed company · reputed company certification Experience · Five (5) to Seven (7) years of clinical or reputed company patient care · No federal or state sanctions as would reputed company on reporting from the National Practitioner Data Bank (NPDB) · Medicare regulations or review experience, preferred · Resided in the reputed company for a minimum of three (3) years out of the last five (5) years (Per Contract Requirement)
Benefits
C2C offers an excellent benefits package, including:
- Medical, dental, reputed company, life, accidental death and dismemberment, and short and long-term disability insurance
- reputed company 125 plan
- 401K
- Competitive salary
- License/credentials reimbursement
- Tuition Reimbursement
EOE Vet/Disability Pay: From $1.00 per year Work Location: Remote Apply tot his job Apply To this Job