Remote Physician Reviewers

We are seeking a Physician Reviewer to support utilization management and appeals processes by reviewing medical records and denial determinations to identify opportunities for appeal. This is an excellent opportunity for recent medical school graduates, including foreign-trained medical graduates, looking to leverage their clinical knowledge in a non-clinical physician review role. They will review medical records, denial letters, and supporting clinical documentation to determine if denied claims are medically necessary and appealable. They will draft and submit approximately 5-6 appeal letters per day using evidence-based clinical rationale. Conduct peer-to-peer reviews with insurance carriers and providers as needed (approximately 1-2 calls per week, up to one hour per call).

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.

• Medical Degree (MD) required.
• Recent medical school graduates encouraged - Foreign-trained medical graduates welcome.
• Strong understanding of clinical documentation, medical necessity, and healthcare delivery.
• Excellent written communication and analytical skills.
• Interest in utilization management, physician advisory services, revenue cycle, or payer-provider relations.

• Connecticut medical license preferred or willingness to obtain one.

Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.