Board-Certified Chiropractor – South CarolinaChiropractor – Physician Reviewer/A Position Available In York, South Carolina
Tallo's Job Summary: Dane Street is hiring a Board-Certified Chiropractor in South Carolina for the role of Physician Reviewer/Advisor. Responsibilities include evaluating insurance appeals and claims for medical necessity, adhering to client-specific policies and national standards of care. Qualifications include a Doctor of Chiropractic degree, board certification, active South Carolina license, and strong analytical skills.
Job Description
Dane Street is seeking a Board-Certified Chiropractor licensed in South Carolina to serve as a Physician Reviewer/Advisor specializing in Independent Medical Exams (IME) . In this role, you will apply your clinical expertise to evaluate insurance appeals, as well as prospective and retrospective claims, to determine the medical necessity of services provided by other healthcare professionals. Your evaluations will adhere to client-specific policies, evidence-based clinical guidelines, and national standards of care.
Key Responsibilities:
Review medical records and address client questions using appropriate clinical guidelines and criteria Deliver clear, concise rationales supported by thorough documentation and evidence Utilize current national, state, and professional guidelines and peer-reviewed literature to support review conclusions Include all criteria and sources used in reviews within submitted reports Complete case reviews within designated timeframes Conduct telephone reviews as required by state or client policy Maintain up-to-date credentialing, licensure, and required certifications Attend required orientation and training sessions Support quality assurance efforts and participate in audits, legal proceedings, or other regulatory processes when needed
Qualifications:
Doctor of Chiropractic (DC) degree Board certification in chiropractic medicine Active clinical practice and current South Carolina chiropractic license Excellent written and analytical skills Familiarity with evidence-based guidelines and utilization review standards
Important Notice:
Dane Street will never conduct interviews via text or request any payment from candidates for equipment or other reasons. Your safety and security are important to us.
