Dane Street wants you to join our dynamic team of expert reviewers! In this role, you will have the opportunity to utilize your medical expertise to conduct thorough reviews of clinical cases. This telework opportunity allows you to customize your schedule as a 1099 independent contractor. Your main task will be to evaluate medical records, provide clinical summaries, engage in peer communications, and answer specific questions posed by our clients. We are on the lookout for talented professionals in the following area: - Cardiology Be a part of a team that values your skills and dedication to improving patient care. Your expertise is vital to helping us deliver high-quality healthcare assessments.

Dane Street wants you to join our dynamic team of expert reviewers! In this role, you will have the opportunity to utilize your medical expertise to conduct thorough reviews of clinical cases. This telework opportunity allows you to customize your schedule as a 1099 independent contractor. Your main task will be to evaluate medical records, provide clinical summaries, engage in peer communications, and answer specific questions posed by our clients. We are on the lookout for talented professionals in the following area: - Cardiology Be a part of a team that values your skills and dedication to improving patient care. Your expertise is vital to helping us deliver high-quality healthcare assessments.

This role is for one of our clients Compensation: $150-$190 per hour We partner with leading AI research teams to enhance the quality, reliability, and real-world usefulness of general-purpose conversational AI systems. These systems are increasingly used in healthcare-related contexts, where accuracy, clarity, and responsible reasoning are critical. This project focuses on evaluating and improving how conversational AI systems respond to medical and healthcare topics. Your clinical expertise will help ensure that responses are factually accurate, clearly explained, clinically sound, and aligned with real-world healthcare standards. Role Overview As a Healthcare Expert, you will apply your professional experience to evaluate and refine AI-generated responses related to medicine, patient care, and healthcare systems. You will help identify inaccuracies, strengthen clinical reasoning, and ensure safe and appropriate communication for diverse healthcare scenarios.

• Perform medical claim reviews for one or more of the following: claims for medically complex services, services that require preauthorization/predetermination, requests for appeal or reconsideration, referrals for potential fraud and/or abuse, and correct coding for claims/operations • Make reasonable payment determinations based on clinical medical information and established criteria/protocol sets or clinical guidelines • Determines medical necessity, appropriateness, and/or reasonableness and necessity for coverage and reimbursement • Monitor process’s timeliness in accordance with contractor standards • Document medical rationale to justify payment or denial of services and/or supplies • Educate internal and external staff regarding medical reviews, medical terminology, coverage determinations, coding procedures, etc. in accordance with contractor guidelines • Participate in quality control activities supporting corporate and team-based objectives • Provide guidance, direction, and input as needed to LPN team members • Provide education to non-medical staff through discussions, team meetings, classroom participation, and feedback • Assist with special projects and specialty duties and responsibilities as assigned by management