$11/hr
Verifying and reviewing patient insurance coverage and benefit eligibility * Resolving patient ... Remote
$11/hr
Verifying and reviewing patient insurance coverage and benefit eligibility * Resolving patient ... Remote
$11/hr
Verifying and reviewing patient insurance coverage and benefit eligibility * Resolving patient ... Remote
$11/hr
Verifying and reviewing patient insurance coverage and benefit eligibility * Resolving patient ... Remote
Staff Psychiatric Mental Health Nurse Practitioner (PMHNP) - Remote | Telehealth | Full-Time or Part
Caguas, PR · On-site +1
$150K - $300K/yr
... peer case reviews. Our vision is to pioneer a new era of medicine by delivering world-class ... Collaborating Physician Coverage: Where applicable, we provide your collaborating psychiatrist and ...
Staff Psychiatric Mental Health Nurse Practitioner (PMHNP) - Remote | Telehealth | Full-Time or Part
Caguas, PR · On-site +1
$150K - $300K/yr
... peer case reviews. Our vision is to pioneer a new era of medicine by delivering world-class ... Collaborating Physician Coverage: Where applicable, we provide your collaborating psychiatrist and ...
Remote Physician Reviewer information
What is a remote physician reviewer?
A Remote Physician Reviewer is a licensed medical doctor who evaluates medical records, claims, or treatment plans from a remote location, typically for insurance companies, healthcare organizations, or government programs. Their main role is to ensure that medical decisions comply with clinical guidelines and regulatory standards without direct patient interaction. They review documentation to determine the medical necessity, appropriateness, and efficiency of healthcare services. This position allows physicians to leverage their clinical expertise in a non-clinical, flexible work environment. Remote Physician Reviewers often communicate their findings through written reports or recommendations.
What does a remote physician reviewer do?
As a remote physician reviewer, your job is to support an insurance company and evaluate patient records to determine whether or not a physician is regularly making good treatment decisions. In this role, you may check health plans to determine whether or not they cover the requested treatments, help process claims, and examine case files to ensure all relevant information is available. This is a remote job, so you can work from home and telecommute when you need to contact others. Remote physician reviewers frequently use critical thinking skills, suggest alternative treatments, and verify the accuracy of information added to the case management system.
What are the key skills and qualifications needed to thrive as a remote physician reviewer?
To thrive as a Remote Physician Reviewer, you need an active medical license, board certification in your specialty, and thorough knowledge of clinical guidelines and medical terminology. Familiarity with utilization management software, electronic health records (EHRs), and secure telecommunication platforms is essential. Strong analytical skills, attention to detail, and clear written communication set outstanding candidates apart. These abilities ensure accurate, timely clinical reviews and effective collaboration with healthcare teams, supporting quality patient care and regulatory compliance.
What are some common challenges faced by remote physician reviewers, and how can they be effectively managed?
Remote physician reviewers often face challenges such as managing a high volume of case reviews, ensuring timely and accurate documentation, and maintaining clear communication with healthcare teams. Balancing workload while adhering to strict deadlines can be demanding, especially when working independently. To manage these challenges, it's important to establish a structured daily routine, utilize secure electronic health record systems efficiently, and stay proactive in seeking clarification or collaboration with colleagues when needed.
What is the difference between Remote Physician Reviewer vs Remote Medical Coder?
| Aspect | Remote Physician Reviewer | Remote Medical Coder |
|---|---|---|
| Required Credentials | Medical degree, medical license, clinical experience | Certification in coding (CPC, CCS), training in medical coding |
| Work Environment | Healthcare organizations, insurance companies, telehealth platforms | Hospitals, billing companies, insurance firms, remote offices |
| Industry Usage | Reviewing medical records, determining medical necessity | Translating medical reports into billing codes |
| Search & Comparison Intent | Understanding clinical review roles, credential requirements | Understanding coding responsibilities, certification needs |
Remote Physician Reviewers focus on evaluating medical records and determining medical necessity, requiring clinical credentials and medical licenses. Remote Medical Coders translate medical documentation into billing codes, requiring coding certifications. Both roles are remote healthcare positions but serve different functions within the industry.
More about Remote Physician Reviewer jobs
What are popular job titles related to Remote Physician Reviewer jobs in Puerto Rico?
For Remote Physician Reviewer jobs in Puerto Rico, the most frequently searched job titles are:
- Remote Physical Medicine And Rehabilitation Physician
- Remote Medical Biller
- Remote Infectious Disease Physician
- Remote Physician
- Night Shift Remote Medical Chart Reviewer
- Remote Dental Clinical Reviewer
- No Experience Moonlighting Physician
- Remote Physician Assistant
- Remote Nurse Reviewer
- Remote Critical Care Physician
What job categories do people searching Remote Physician Reviewer jobs in Puerto Rico look for?
The top searched job categories for Remote Physician Reviewer jobs in Puerto Rico are:
PART TIME: Patient Service Representative - English Speaking/Bilingual, Puerto Rico based
Remote
$11/hr
Part-time
Retirement, PTO
Re-posted 20 days ago
Job description
Job description:
Please note that this role is ONLY open to candidates currently residing in Puerto Rico.
Mission Statement
We connect patients, providers, and caregivers to the right care, at the right time, in the right place, resulting in exceptional experiences and outcomes for patients and providers.
Our vision is to be the partner of choice for healthcare organizations in the delivery of patient access solutions.
The specific behaviors and skills we care about most are Integrity, Innovation, Collaboration, Empathy and Excellence.
Summary
We are rapidly expanding and we are looking for Patient Scheduling Representatives who reside in Puerto Rico and are available to work remotely.
We specialize in connecting patients, providers and caregivers ensuring that patients can access the right care at the right time and in the right place. We are a multidisciplinary team of nurses, contact management specialists and technologists who work with leading hospital and health organizations.
Shift pattern:
Shifts between 9am - 2pm, Monday to Friday
We also Provide 15 PTO days as part of the role.
Key Duties:
- Receiving inbound calls from patients looking to schedule physician appointments
- Connecting patients, providers and caregivers to the right care, at the right time, in the right place, resulting in an exceptional experience and outcome for patients and providers
- Verifying and reviewing patient insurance coverage and benefit eligibility
- Resolving patient requests efficiently
- Accurately entering patient data into multiple systems
Candidate Requirements:
- Must be resident in Puerto Rico
- Must be able to work remotely
- Must have fixed line broadband internet connectivity
- Exceptional customer service skills
- Empathy and the ability to soothe anxious callers
- Previous customer service experience (face to face or contact center)
- Excellent communication skills, both written and verbal
- Fluent English and the ability to relay information to callers in an easily understood manner
- Ability to multitask
- Computer literacy and ability to learn new systems
- Adaptability to changes in processes and procedures
Benefits:
- 401(k)
- Employee assistance program
- Paid time off
Experience:
- customer service: 1 year (Preferred)
Language:
- English (Required)
Location:
- Puerto Rico (Required)
Work Location: Remote
About Relatecare
Sourced by ZipRecruiter
Company size
51 - 200 Employees
Headquarters location
Cleveland, OH, US
Year founded
2012