Board Certified Physician Reviewers (MD, DO) - Multiple Specialties

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Requirements:

• Current, unrestricted Medical License is required.
• Active practice in medical field.
• Must be Board Certified in relevant specialties.
• Must be an expert in the treatment of covered medical conditions.

Responsibilities:

• Reviews all medical records and addresses client-specific questions using recognized criteria.
• Ensures a clear rationale for determinations with supporting documentation.
• Identifies and utilizes appropriate guidelines and resources for decision-making.
• Returns cases by the due date and makes mandated telephone calls.
• Participates in Panel Hearing calls and writes reports post-hearing.