Regional Physician Advisor Position (Southeast) Coastal Virginia Near the Beach

Overview Sentara Health is seeking to hire a qualified individual to join our team as Regional Physician Advisor. Position status: Full-time, Day Shift. Location: On-site. Standard Working Hours: 8:00 AM to 5:00 PM (ET). Responsibilities The Regional Physician Advisor supports the Clinical Revenue Cycle’s Utilization Review and Denials/Appeals processes to determine and secure appropriate level of care assignments to ensure compliant billing, assist with denials management, support documentation integrity as it pertains to accurate coding capture. The Advisor interfaces with hospital and medical staff leadership, facilitating communication between Revenue Cycle leadership and processes and the hospital facilities and championing processes and initiatives. The Advisor assists with both formal and informal education of medical staff at Sentara hospital facilities. This role is responsible for supporting and meeting the Clinical Revenue Cycle functions organizational goals and objectives for assuring the effective, efficient utilization of health care services. Qualifications Completion of Medical doctorate or Doctor of Osteopathy degree from an accredited medical school Completion of an accredited residency training program Minimum of 5 years of clinical experience, 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 Possess or acquire a thorough understanding of CMS regulatory guidance and requirements as they pertain to UR and site of service decisions Possess a 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 and patient specific variables as may be necessary or justifiable Familiarity with (Hospital) organization and case management operations Excellent customer service and interpersonal skills Able to effectively present information, both formal and informal Superb written and verbal communication skills Strong organizational and analytic skills, and ability to set and manage priorities Demonstrate flexibility, teamwork, and a collaborative leadership style Strong technical/computer skills and working knowledge of the system’s EMR Ability to provide a consistent on-site presence at assigned sites Benefits 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 401k/403B with Employer Match Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education Student Debt Pay Down – $10,000 Reimbursement for certifications and free access to complete CEUs and professional development Pet Insurance Legal Resources Plan Annual discretionary bonus possible if established criteria are met Equal Employment Opportunity Sentara Health is an equal‑opportunity employer. #J-18808-Ljbffr