Doctor of Medicine - Consultant

Position Overview: We are seeking a Board-Certified Doctor of Medicine (MD) or Doctor of Osteopathy (DO) in a specialty recognized by the American Board of Medical Specialties. This short-term consulting role involves providing expert medical guidance in claims review processes, particularly within the behavioral health domain. Responsibilities: • Serve as a source of medical information to guide insurance coverage determinations in specific claims review situations. • Conduct primary reviews or secondary-level medical reviews to validate initial findings. • Apply extensive knowledge of Medicare and Medicaid programs in evaluating claims. Qualifications: • Board-certified physician (MD or DO) in an ABMS-recognized specialty. • Minimum of 3 years of experience in the health insurance industry. • Actively practicing and licensed in the state where you reside. • In-state and like-licensed (must match the jurisdiction of practice). • Proficient in both spoken and written Spanish. • Specialty focus: Applied Behavioral Analysis (ABA) and Psychology. Contract Details: • Short-term, part-time engagement. • Fully remote, with the requirement to be physically located in the state of your medical license. About Seneca Resources: Seneca Resources is a client driven provider of strategic Information Technology consulting services and Workforce Solutions to government and industry. Seneca Resources is a leading IT services provider with offices in Virginia, Alabama, Georgia, North Carolina and New York that service clients throughout the United States. We are an Equal Opportunity Employer and value the benefits of diversity in our workplace. Apply tot his job