Physician Reviewer (Weekend Work)

Job description

**Please make sure your application is complete, including your education, employment history, and any other applicable sections. Initial screening is based on the minimum requirements as defined in the job posting, such as education, experience, licenses, and certifications. Your experience should also address the knowledge, skills and abilities needed for the role. Incomplete applications will not be considered.** *This position is located Remote United States* *This can be a full-time or part-time role* Position Purpose: Provides dissatisfied beneficiaries and/or providers/suppliers the opportunity to present documentation to demonstrate why an appeal should be allowed. Provides a denovo independent second level determination based on the documentation, facts, laws, regulations, and guidelines. Essential Responsibilities: - Writes, and may plan, a reconsideration decision that is clear and supports the determination made. - Makes sound, independent decisions based on medical evidence in accordance with statutes, regulation, rulings, Centers for Medicare & Medicaid Services (CMS) policy, and local Medicare policy, or other authoritative sources. - Ensures, and may plan, that all...