|
|
|
|
| Employer Name: InsurCrossing |
SpiderID: 2290747 |
| Location: Westbrook, Maine |
Date Posted: 6/17/2008 |
| Wage: |
Category: Insurance |
| Job Code: |
|
Job Description:
The Medical Director is responsible for the enhancement of Disability RMS' claims management by serving as a higher-level medical consultative resource. Responsibilities include the review of clinical records and communications with providers and other parties to facilitate the clinical aspects of claim management and benefits determination process. Job Responsibilities: Performs a critical review and analysis of medical information with regard to diagnosis, treatment, prognosis and duration of the conditions, forms a conclusion, and clearly communicates the rationale Maintains satisfactory productivity in reviewing cases Completes written and verbal consultations with all levels of the claims staff that will clearly outline the answers on functional parameters as well as the length and severity of the medical condition(s) Holds walk in consultation meetings with claims staff regarding disability claims, capturing essential elements of a file Ensures quality investigations of medical information utilizing the resources available Reviews and evaluates Independent Medical Examination (IME) reports Assists with the development of return to work plans Maintains knowledge and skills regarding medical advances and communicates/educates claims staff in one on one meetings Continues to research rare/unusual medical conditions and be knowledgeable on the tools necessary to perform this research Communicates verbally and in writing with providers, subscribers and other appropriate contacts in a professional and effective manner, resolving discrepancies and clarifying medical information, including diagnosis, treatment, prognosis, restrictions, limitations, and duration of conditions Maintains MD license Qualifications: Current and valid physician license in the State of Maine 3-5 years of clinical experience required Strong knowledge of medical treatment protocols Experience in utilization review/health care industry insurance preferred Strong research, analytical, critical thinking, problem solving skills and decision-making skills Ability and desire to work in a fast-paced, service-oriented environment Excellent verbal communication skills, with the ability to be both pleasant and professional Strong written communication skills Ability to work well independently and in a team environment Strong interpersonal and customer service skills Ability to initiate and prioritize regular work duties and projects Detail oriented, organized, the ability to multi-task, and strong time management skills Strong computer skills, proficient in PC environment and MS Word, Excel, and Outlook Ability to work profesionall and effectively with co-workers, clients, claimants, vendors and others with whom DRMS does business Equal Opportunity/Affirmative Action Employer M/F/D/V
For more information of this job and to Apply Online, please Click Here
For more Insur Jobs please Click Here.
Job Criteria:
Start Date:
Position Type: Full-Time Permanent
Years of Experience Required:
Education Required:
Overnight Travel:
Vacation Time:
Contact Information:
| Contact Name: - |
Company Type: Employer |
| Company: InsurCrossing |
|
|
|
| City: Pasadena |
|
| State: California |
|
| Zip: |
|
Web Site: http://www.insurcrossing.com
|
|
|
|
|
|
|