City/State
Norfolk, VAOverview
Work Shift
First (Days) (United States of America)Job Summary
The Physician Advisor conducts timely and compliant medical necessity reviews and assists with denials management (facilitating and completing peer to peers, writing appeal letters) in support of the centralized system Utilization Review (UR) process for Sentara hospital facilities. The Physician Advisor serves an important role in ensuring compliant hospital status/billing for hospital patients and strengthening relationships between Clinical Revenue Cycle, UR, hospital leadership, medical staff, and hospital ICM. The Physician Advisor interfaces directly with the medical staff, providing concurrent communication and education to attending physicians (and their APCs) regarding recommended changes in hospital status, pertinent regulatory requirements and guidance impacting the determination, as well as documentation integrity to support medical necessity of services being delivered.Qualifications:
MD - Doctor of Medicine: Doctor Of Osteopathic Medicine (Required), MD - Doctor of Medicine (Required)Doctor of Osteopathic Medicine (DO) - Certification - North Carolina, Doctor of Osteopathic Medicine (DO) - Certification - Other/National, Doctor of Osteopathic Medicine (DO) - Certification - Virginia, Medical Doctor (MD) - Certification - North Carolina, Medical Doctor (MD) - Certification - Other/National, Medical Doctor (MD) - Certification - VirginiaClinicalSkills
Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.
In support of our mission "to improve health every day," this is a tobacco-free environment.