Medical reviewer jobs in Bay Shore, New YorkCreate job alerts

Job Description Company: Schultheis & Panettieri, LLP Position: Audit Manager, Reviewer Job Location: Hauppauge, NY Salary Range: $100,000-$150,000 Looking to work at a firm that encourages a work/life balance? We are a growing midsize CPA firm specializing in the audits of labor unions and their related fringe benefit funds. We have three locations. Our home office is in Hauppauge and we have offices in Iselin, NJ and Floral Park, NY. We are currently looking for a Full- Time or Part-Time experienced Audit Manager focusing on Quality Control. This position requires a CPA license. Responsibilities include: • Detailed review of engagements, • Compliance with GAAP, • Review of tax returns: 990's, LM-2's, 5500's, • Functioning as a Firm resource on the research of technical issues involving complex accounting, auditing, and other regulatory matters, • Preparing position papers and implementation guidance regarding newly issued technical pronouncements, • 10+ years of progressively challenging Public Accounting experience, • Experience with labor unions, multi-employer employee benefit funds preferred but not required, • Ability to research complex accounting and auditing issues, • Time management skills Benefits include: • Medical, Dental, Vision, • Life Insurance, LTD, Flex Spending, • Sick/Vacation time, • 401(k) / PENSION- EMPLOYER CONTRIBUTION OF UP TO A TOTAL OF 15% TO YOUR RETIREMENT!!, • Remote capability, • Flexible work schedule

Job Description Requirements As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide 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. MAJOR DUTIES AND RESPONSIBILITIES: • 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 PLEASE BE AWARE: In the interest of the security of all parties, Dane Street will never conduct interviews via text or request checks from candidates for any reason including the purchase of equipment. Benefits • Robust opportunity for supplemental income, • Schedule flexibility and predictable work hours - You choose services and case types, dictate volume, and conduct exams and reviews based on your schedule availability, • No doctor/patient relationship is established and no treatment is provided. These are advisory-only opinions., • Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management expertise, • Expanded credentials as an expert in Independent Medical Exams and physician advisor services, • Fully prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal Dane Street supports all referral processes, scheduling, preps cases extensively, prepares all medical records, provides transcription services as applicable, facilitates all client communications, and ensures the quality and timeliness of all reports and report delivery. Apply for this job