As an expert clinical reviewer, you will evaluate insurance claims and appeals to ensure adherence to established policies, guidelines, and standards of care. Key Responsibilities: 1. Conduct thorough medical record reviews and address client inquiries using evidence-based criteria. 2. Ensure clear and concise decision rationale with adequate documentation. 3. Utilize current national, state, and professional guidelines, as well as peer-reviewed literature, to inform objective decision-making. 4. Provide copies of utilized standards with the review report in a timely manner. 5. Complete reviews on or before the assigned deadline. 6. Maintain required certifications, licenses, and credentials. 7. Participate in orientation and training sessions. 8. Perform additional duties including quality assurance, regulatory compliance, and audit participation. Board certification and active practice are mandatory requirements. Benefits: - Supplemental income, flexible scheduling, and no direct patient relationship. - Enhance your industry expertise and credentials in independent medical evaluation and physician advisory services. - Case preparation, transcription, and client communication support provided by the organization.