Regional Physician Advisor Position (Eastern/Peninsula) Coastal Virginia Near the Beach

Overview Sentara Health is seeking to hire a qualified individual to join our team as a Regional Physician Advisor. The position is full‑time, day shift on‑site with standard hours 8:00AM–5:00PM (ET). Responsibilities Support the Clinical Revenue Cycle’s utilization review and denials/appeals processes to determine and secure appropriate level of care assignments for compliant billing. Assist with denials management and maintain documentation integrity to ensure accurate coding capture. Interface with hospital and medical staff leadership, facilitating communication between revenue cycle leadership and hospital facilities, and championing process initiatives. Provide both formal and informal education to medical staff at Sentara hospital facilities. Support and meet the Clinical Revenue Cycle functions’ organizational goals and objectives for effective and efficient use of health care services. Qualifications Completion of a medical doctorate (MD) or Doctor of Osteopathy (DO) degree from an accredited medical school. Completion of an accredited residency training program. Minimum of 5 years of clinical experience, with hospital clinical experience strongly preferred. Minimum of 2 years of physician advisory experience strongly preferred. Active and unrestricted state Virginia medical license. Board certification in specialty required at time of hire. Understanding of CMS regulatory guidance and requirements related to utilization review and site of service decisions. Working knowledge of clinical documentation integrity, hospital billing and coding processes and guidelines, case mix index, and DRG assignments. Familiarity with standard published leveling criteria such as MCG/Interqual and ability to apply professional judgment. Familiarity with hospital organization and case management operations. Excellent customer service and interpersonal skills. Ability to present information formally and informally. Strong written and verbal communication skills. Strong organizational and analytic skills with ability to set and manage priorities. Demonstrated flexibility, teamwork, and a collaborative leadership style. Strong technical/computer skills and working knowledge of EMR systems. Ability to provide a consistent on‑site presence at assigned sites. Benefits Caring for your family and career: Medical, Dental, Vision plans; adoption, fertility and surrogacy reimbursement up to $10,000; paid time off and sick leave; paid parental & family caregiver leave; emergency backup care; long‑term, short‑term disability and critical illness plans; life insurance; 401(k)/403(b) with employer match; tuition assistance – $5,250/year and discounted educational opportunities; student debt pay‑down – $10,000; reimbursement for certifications and free access to CEUs and professional development; pet insurance; legal resources plan. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its workforce. The organization strives to ensure its workforce reflects the communities it serves. #J-18808-Ljbffr