As our Physician Advisor, you will help our client facilities navigate the path to compliant revenue by reviewing payor peer-to-peer cases. Every day. You will review cases for which authorization has been denied, evaluating if the proper documentation was available for the admission status, procedure, and care setting that was requested.  You will also advise our clients regarding the appropriateness of the request based on available documentation, as well as discuss the cases with medical directors from the payor side. 

To thrive in this role, you must have strong clinical knowledge across multiple clinical areas and be capable of working independently with a high level of performance in a rapidly changing, fast-paced environment.  Proficiency in basic computer skills is essential for excelling in this remote position.

Here’s what you will experience working as a Physician Advisor:

• Addresses the following issues: authorization requested, documentation support or lack of support for that authorization, evidence-based criteria for that support, and complex clinical evaluation of the request as a whole.

• Review and respond to the payor and customer in a timely manner.

• Actively engage with payor medical directors to discuss appropriate authorization status as supported by documentation.

• Provide written analysis of the case and perform case reviews across multiple specialties.

• Serve as a clinical resource to medical and case management staff by providing identification, facilitation, and resolution of documentation and utilization issues.

Required Skills:

• Active, unrestricted MD or DO medical licensure

• Minimum 3+ years of clinical experience post-residency completion

For this US-based position, the base pay range is $145,000.00 - $199,070.29 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.

This job is eligible to participate in our annual bonus plan at a target of 10.00%