A company is looking for a Medical Claims Review Medical Director - Physiatrist - Remote.
Key Responsibilities Conduct coverage reviews based on individual member plan benefits and render coverage determinations Document clinical review findings and actions in accordance with policies and regulatory requirements Engage in peer-to-peer discussions with requesting providers as needed Required Qualifications M.D. or D.O Active unrestricted license to practice medicine Board certification in Physical Medicine and Rehabilitation 5+ years of clinical practice experience after completing residency training Proven sound understanding of Evidence Based Medicine (EBM)