Board Certified Pulmonology Physician Reviewer - California License

Dane Street is an Independent Review Organization and a national provider of Utilization Review services (among other offerings) and we are expanding our physician panel resulting in opportunities for non-traditional physician work and supplemental income. This is a telework opportunity for physicians providing a caseload customized to your schedule.

Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case basis. We are looking for physicians who are board certified in Pulmonology/Pulmonary Disease with active California licenses with experience in the California Independent Medical Review (IMR) process. IMR serves as a binding appeals process for disputes arising from the denial or modification of workers’ compensation treatment requests. Since July 1, 2013, all medical treatment disputes—regardless of the date of injury—are resolved through IMR rather than the traditional court system, streamlining the process significantly.

In California’s workers’ compensation system, all treatment requests undergo utilization review (UR) to determine medical necessity. If a request is denied, delayed, or modified due to lack of medical necessity, the injured worker has the right to appeal the decision through IMR. This review is conducted by physicians who assess the case using evidence-based guidelines.

IMR physicians must be experts in the Medical Treatment Utilization Schedule (MTUS), Official Disability Guidelines (ODG), and medicolegal writing, as they are responsible for evaluating medical necessity based on established standards and clearly articulating their rationale in written determinations.

Preferred but Not Required:

• California IMR experience

Highlights:

• Consistent volume
• Good reimbursement
• The work can be done any time (outside standard work hours)
• No calls are required

• Provided the IMR reviewer training manual to review and assist in making your experience with this work even more efficient

Training and onboarding can be completed in less than 1 week and you can start earning compensation for reviews while maintaining your active practice. Contact us today about joining our panel of specialty reviewers!

Requirements

• Current, unrestricted California Medical License
• Active Practice
• Board Certified

Benefits

• Independent consultant role allows for schedule flexibility and predictable work hours. You choose services and case types, dictate volume, and conduct this work based on your scheduled availability
• No doctor/patient relationship is established and no treatment is provided. These are advisory-only opinions
• Typical TAT is 7 business days depending on the level of review. Dane Street keeps you apprised of required turn-around time and carefully coordinates all administrative tasks so your time is spent on clinical decision-making
• Dane Street offers a streamlined case flow and a user-friendly work portal. We facilitate all communication, organize and sort all medical records, support all administrative processes, prep cases extensively, and ensure the quality and timely delivery of all determinations/reports
• Dane Street offers initial training as well as an ongoing point of contact should you have any questions about completing reviews

Originally posted on Himalayas