Dane Street
Fort Mill, SC, USA
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...