Remote Physician Reviewers

Physician Reviewer

We are seeking a physician reviewer to support utilization management and appeals processes by reviewing medical records and denial determinations to identify opportunities for appeal. This is an excellent opportunity for recent medical school graduates, including foreign-trained medical graduates, looking to leverage their clinical knowledge in a non-clinical physician review role. They will review medical records, denial letters, and supporting clinical documentation to determine if denied claims are medically necessary and appealable.

They will draft and submit approximately 5-6 appeal letters per day using evidence-based clinical rationale. Conduct peer-to-peer reviews with insurance carriers and providers as needed (approximately 1-2 calls per week, up to one hour per call).