Providing physician-level radiology expertise, the full-time California Licensed Radiologist Reviewer will review radiology-related claims, Treatment Authorization Requests (TARs), and medical records remotely to ensure compliance with medical necessity and coverage requirements. Key responsibilities Review radiology-related claims and medical records to evaluate compliance with medical policies and coverage requirements Provide clinical expertise for complex radiology cases and support medical necessity determinations Document review findings and collaborate with healthcare professionals to ensure accurate assessments Required qualifications Minimum of three (3) years of experience as a Radiologist in a private, academic, or government setting Current, non-expired physician license from the State of California in good standing Not under suspension from Medicare, Medicaid, or practice in California Not previously sanctioned for fraud or abuse Strong clinical judgment with the ability to interpret complex radiology-related medical records
California Licensed Radiologist Reviewer in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.