Orthopedic Surgery- Need for Treatment Examination (NFT) at Blank Street

Myrtle Beach, South Carolina, United States

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Not SpecifiedCompensation

Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, InsuranceIndustries

Requirements

Reviews all medical records and addresses each question posed by the client utilizing client specific criteria or other nationally recognized evidence-based criteria
Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision
Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes
Provides copies of any criteria utilized in a review with the report in a timely manner
Returns cases on or before the due date and time
Makes telephone calls as mandated by the state and/or client specifics
Maintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the job
Attends all required orientation and training
Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits
Board certification required
Active practice required

Responsibilities

Utilizes clinical expertise and reviews insurance appeals, and prospective and retrospective claims
Provides an interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client specific policies, nationally recognized evidence-based guidelines, and standards of care

Skills

Key technologies and capabilities for this role

Orthopedic SurgeryIndependent Medical ExamsMedical Necessity ReviewInsurance AppealsEvidence-Based GuidelinesPeer-Reviewed LiteratureMedical Record ReviewUtilization ReviewBoard CertificationActive Medical Practice

Questions & Answers

Common questions about this position

What benefits does this position offer?

The role provides robust supplemental income opportunities, schedule flexibility with predictable hours where you choose services and case types, no doctor/patient relationship or treatment involved, enhanced industry expertise, expanded credentials, fully prepped cases, streamlined workflow, free transcription services, and comprehensive support for referrals, scheduling, and client communications.

Is this position remote or on-site?

This is an on-site position.

What are the key requirements for this role?

Board certification and active practice are required, along with maintaining proper credentialing, state licenses, and any special certifications needed.

What is the compensation for this position?

This information is not specified in the job description.

What makes a strong candidate for this Physician Reviewer role?

Candidates should have board certification, active clinical practice, and the ability to review medical records using evidence-based criteria, provide clear rationales, meet deadlines, and handle quality assurance or regulatory issues.

Blank Street

Specialty coffee shop with efficient service

About Blank Street

Blank Street provides a unique coffee shop experience by offering high-quality coffee and food at affordable prices. The company started with a small coffee cart in Brooklyn and has since expanded to major cities like New York, London, Boston, and Washington, D.C. Their product offerings include specialty coffees sourced from around the world and fresh, locally-sourced food. Customers can enjoy a quick yet premium experience, thanks to the efficiency of their small locations that help keep costs down. Blank Street differentiates itself from competitors by focusing on customer convenience through technology, such as their app that allows for ordering ahead, customizing drinks, and participating in loyalty programs. They also prioritize employee satisfaction by paying baristas above-market wages. The goal of Blank Street is to redefine the coffee shop experience by combining quality, affordability, and exceptional service, making it a significant player in the specialty coffee market.

New York City, New YorkHeadquarters

2020Year Founded

$50.6MTotal Funding

EARLY_VCCompany Stage

Food & Agriculture, Consumer SoftwareIndustries

201-500Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Paid Vacation

Paid Sick Leave

Paid Holidays

Parental Leave

Flexible Work Hours

Company Equity

Risks

Rapid expansion may lead to operational inefficiencies and overextension.

Subscription program may not resonate with all customer segments, risking dissatisfaction.

Reliance on outsourced vendors poses risks if supply chain disruptions occur.

Differentiation

Automated espresso machines ensure consistent quality and enhance barista-customer interaction.

Small, cost-effective locations reduce overhead and allow competitive pricing.

Focus on high-quality, clean, and natural products at affordable prices.

Upsides

Rapid expansion into major cities increases brand visibility and market presence.

Subscription model provides steady revenue and enhances customer loyalty.

Partnerships with lifestyle brands boost brand visibility and customer engagement.

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