Medical Claims Review Medical Director - Surgeon - Remote

For our client, we are seeking a Medical Claims Review Medical Director - Surgeon - Remote to join the team of a leader in the Healthcare space. This role will support clinical priorities focused on quality, patient-centered outcomes, and effective care delivery. You will collaborate with clinical leaders, operational teams, and cross-functional stakeholders to improve standards, workflows, and execution. The position offers the opportunity to strengthen care quality, team performance, and measurable outcomes within a healthcare environment. Location: Remote - US based candidates only, no visa sponsorship available Compensation: $248,500 – $373,000 annually Responsibilities Conduct coverage reviews based on member plan benefits Document clinical review findings and actions Engage in peer-to-peer discussions with requesting providers Interpret benefit language in clinical coverage reviews Participate in daily clinical rounds when requested Collaborate with providers for accurate benefit determinations Communicate with internal partners for operational efficiency Qualifications M.D. or D.O. required Active unrestricted medical license with ability to obtain additional licenses Current board certification as a Surgeon 5+ years of clinical practice after residency Strong understanding of Evidence Based Medicine (EBM) Proficient with MS Word, Outlook, and Excel Benefits Comprehensive benefits package Incentive and recognition programs Equity stock purchase options 401k contribution plans Remote work flexibility from anywhere in the U.S Our client is an equal opportunity employer. We encourage you to apply even if you don’t meet every qualification—your background could be exactly what this team needs. Show more Show less