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State Licensed Physician Advisor

workfromhome • Posted 5 days ago
Remote Part Time Healthcare Practitioners and Technical Occupations

To support client facilities in navigating compliant revenue processes, the full-time remote State Licensed Physician Advisor will review payor peer-to-peer cases, evaluate documentation for authorization denials, and engage with payor medical directors regarding case appropriateness. Key responsibilities: Evaluate authorization requests and associated documentation to determine compliance and appropriateness Engage with payor medical directors to discuss authorization status and provide timely responses to inquiries Serve as a clinical resource for medical and case management staff, addressing documentation and utilization issues Required qualifications: Active, unrestricted MD or DO medical licensure Minimum of 3 years of clinical experience post-residency completion Strong clinical knowledge across multiple areas Proficiency in basic computer skills Ability to work independently in a fast-paced environment

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