To lead the claims review program effectively, the remote Medical Director of Orthopedic Surgery will manage the quality and coordination of medical services, participate in claim reviews, and serve as a liaison between Optum and medical providers. Key responsibilities: Review surgical and professional claims for correct coding using clinical records Discuss cases and clinical coding with treating providers during scheduled telephonic discussions Support compliance with regulatory standards and provide clinical support for initial review staff Required qualifications: MD or DO with a current, active, and fully unrestricted medical license Current board certification in Orthopedic Surgery through ABMS or AOA 5+ years of clinical experience post-residency Proficiency in MS Office (Word, Excel, PowerPoint)
Orthopedic Surgery Medical Director in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.