- CommonSpirit Health (Englewood, CO)
- …opportunities.** We are seeking a highly skilled individual to develop and submit clinical appeals , expertly crafting physician -aligned letters based on ... and understanding of documentation importance + Assist in communications of internal physician advisor services in the hospital newsletters and other… more
- Nuvance Health (Danbury, CT)
- …support inpatient level of care. If the case still does not meet, send to the Physician Advisor (PA) for a second level review. * Forward cases that require ... in preventing payment denials by providing timely and accurate clinical information to all payers, while ensuring compliance with...secondary physician review to appropriate resource (eg, Physician Advisor ). * Resolve any discrepancy at… more
- Catholic Health Services (Melville, NY)
- …timeframes. + Collaborates in clinical discussions with the Catholic Health Physician Advisor when appropriate. + Reviews results from managed care payors ... Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews...documentation. + Acts as liaison between the Utilization and Appeals Management Department and the physician of… more
- Catholic Health Services (Melville, NY)
- …Manage Care Payors or regulatory agencies, as needed or requested. + Manages physician advisor reports and assists with facilitating UM Committee reviews when ... liaison between patient account services, physicians, care coordinators, Utilization and Appeals Managers, physician advisors and facility departments. +… more
- Mohawk Valley Health System (Utica, NY)
- …level of care, patient billing status, and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure ... and efficient utilization of resources. The Physician Advisor guides the team to improve clinical ...staff. + Assist case managers with Medicare and Medicaid appeals and Administrative Law Judge (ALJ) testimonies. Act as… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …levels of healthcare quality and acceptable levels for the cost of care. 3. The Physician Advisor will conduct clinical reviews on cases referred by ... **Job Summary and Responsibilities** 1. The Physician Advisor serves the Hospital through...PHYSICIAN LIAISON:** * Discuss cases with the attending physician and whether additional clinical information is… more
- Trinity Health (Silver Spring, MD)
- **Employment Type:** Full time **Shift:** **Description:** **Position Title:** Physician Advisor **Type of Position:** Exempt **What We Offer:** Benefits, Free ... distance from Washington, DC, and Baltimore, MD. **Position Overview:** The Physician Advisor provides expertise related to appropriate utilization/level of… more
- CommonSpirit Health (Englewood, CO)
- …Summary and Responsibilities** **Thi** **s is a remote position** The Utilization Management Physician Advisor II (PA) conducts clinical case reviews ... the submission of necessary documentation. + Assists in communications of internal physician advisor services in the hospital newsletters and other communication… more
- AdventHealth (Orlando, FL)
- …Utilization Management/Medicare Regulations . Two years or greater experience as a Physician Advisor . Three years of leadership experience **LICENSURE, ... clinical documentation improvement opportunities and relevant data. Provide physician coaching on documentation. Assist in billing for technical component of… more
- Ascension Health (Jacksonville, FL)
- **Details** + **Specialty** : Case Management + **Subspecialty:** Physician Advisor + **Schedule** : Full Time | Hybrid (frequently on site) + **Call Schedule:** ... time of the offer._ **Responsibilities** **Position Highlights** Ascension St. Vincent is looking for a Physician Advisor to join our team. We are looking for a … more
- Ascension Health (Hoffman Estates, IL)
- **Details** + **Specialty** : Physician Advisor + **Schedule:** Full Time | Onsite + **Practice Details:** Join experienced Case Management Team + **EMR** ... time of the offer._ **Responsibilities** **Position Highlights** Ascension St. Alexius is looking for a Physician Advisor to join our team. We are looking for a … more
- Hackensack Meridian Health (Manahawkin, NJ)
- …a highly motivated and experienced physician to join our team as a ** Physician Advisor ** . This vital role offers a unique opportunity to combine your ... clinical expertise with leadership skills to optimize patient care...(eg, MCG, InterQual). + Conduct utilization reviews and manage denials/ appeals . + Collaborate with physicians and staff to promote… more
- Billings Clinic (Billings, MT)
- …sessions on the full circle of proper revenue cycle practices regarding clinical documentation, coding, reimbursement, denials and appeals . Strives to maximize ... a difference here. About Us Billings Clinic is a community-owned, not-for-profit, Physician -led health system based in Billings with more than 4,700 employees,… more
- Trinity Health (Davenport, IA)
- …, patient and Genesis Medical Center needs. Serve as primary contact for clinical physicians, physician 's billing office and Genesis Medical Center departments. ... and insurance organizations regarding pre-certification issues. Initiate and follow up on appeals for denied payments. Will ensure that all activities achieve high… more
- Nuvance Health (Danbury, CT)
- …prioritize improvement efforts, and negotiate with payers for fair reimbursement. * * Physician Advisor Collaboration:* Collaborate with the physician ... and operational oversight for a team of utilization review staff, denials and appeals specialists, non- clinical support staff while partnering with local case… more
- CommonSpirit Health (Phoenix, AZ)
- …of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred. + Physician Advisor Sub-specialty Certification by the American Board of ... federal, state and payer regulatory and contract requirements. + Previous Physician Advisor /Care Management or equivalent experience. Excellent communication… more
- Mount Sinai Health System (New York, NY)
- …to reduce readmission rate. h. Appropriately identifies and refers cases to the physician advisor to support timely progression of patients along the continuum ... d. Works collaboratively with physicians and managed care companies on concurrent denial appeals e. Communicates clinical information to the payor, as needed,… more
- Blue KC (MO)
- …reviews on quality complaints, sentinel events, and quality-of-care referrals. + Serves as physician advisor for other areas within the company, including but ... submitted clinical records, external telephonic conversations with the providing physician in the form of Peer-to-Peers, and close collaboration with the nursing… more
- Sharp HealthCare (San Diego, CA)
- …regard to Plan policy as needed.Completes and/or supervises the completion of all clinical appeals and grievances. Collaborates with Customer Care Manager to ... (Medical Directors (both medical and behavioral health) and the Physician Reviewers) to coordinate the necessary co-management of our...membership. Serves as a lead medical manager and policy advisor to SHP clinical and its' Chief… more
- Ascension Health (Jacksonville, FL)
- …of High Reliability Organization principles for physician activities. + Serves as physician advisor to assist with level of care, length of stay, denial ... an advocate on behalf of our patients, physicians and clinical staff. Identifies, cultivates and develops emerging physician...management, appeals , and peer to peer reviews. + Performs other… more