Physician Reviewer - (Radiation Oncology, Cardiology, Rheumatology)

Dallas, Texas, United States

Apply with AI Apply

Not SpecifiedCompensation

Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Medical ReviewIndustries

Requirements

Candidates should possess a medical degree and a valid license in North Carolina, Texas, Minnesota, or New Mexico, along with any special certifications or requirements necessary to perform the job. Strong clinical expertise and familiarity with insurance appeals and claims are essential, as is the ability to interpret medical necessity and apply evidence-based guidelines.

Responsibilities

The Physician Reviewer will utilize clinical expertise to review insurance appeals and prospective/retrospective claims, providing interpretations of medical necessity in compliance with client policies and standards of care. They will ensure clear and concise rationales with adequate supporting documentation, identify and critique relevant criteria and resources, and deliver reports adhering to due dates. The role also includes maintaining proper credentialing, attending required training, and addressing quality assurance, regulatory, and legal issues as needed.

Skills

Radiation Oncology

Cardiology

Rheumatology

Ophthalmology

Otolaryngology

OB/GYN

Hematology/Oncology

Medical Record Review

Insurance Appeals

Clinical Expertise

Evidence-based Guidelines

Standards of Care

NM License

TX License

MN License

NC License

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.

Land your dream remote job 3x faster with AI

Try Jobo Free