Physician Advisor

We are a full-service denial and appeals management company that actively pursues the recovery of funds from health insurance payors who have wrongfully denied claims, underpaid claims, or who are extremely slow to pay. Job Description We’re looking for self‑motivated FT/PT Physician Advisors to join our team. The Physician Advisor serves as a clinical resource to medical staff by providing identification, facilitation and resolution of utilization issues. The Physician Advisor addresses the following issues: peer to peer reviews, compliance, level of care, length of stay, hospital reimbursement and quality issues for our hospital clients. The Physician Advisor also serves as an expert on appeals and will represent client hospitals where claims were denied by either governmental contractors or commercial payers. The position will involve a thorough review of patient clinical and hospital course documentation and payer policy and denial information. Qualifications Candidates must apply on our website for consideration A successful candidate must have: Active, unrestricted MD or DO medical licensure Experience in a clinical environment and the ability to use sound judgment in reviewing clinical documentation supporting patient care. At least 3 years of experience post‑residency, clinical practice experience Strong clinical knowledge base Must be computer proficient Strong verbal and written communication skills Must be professional, organized and possess persuasive writing and speaking skills Possess strong negotiating/reasoning/logic and problem‑solving skills Must have the ability to perform case reviews across multiple specialties Able to play a dynamic role with ability to adapt to constant change as needs change Additional Information All your information will be kept confidential according to EEO guidelines. #J-18808-Ljbffr