External Physician Reviewer

AFMC; Little Rock (AR); Remote; USD 150,000 - 250,000; Full time

Job summary

An established industry player is seeking qualified physicians to join their team for prior authorizations and retrospective reviews. This role offers the flexibility of working from home while ensuring essential medical services are delivered effectively. Ideal candidates will hold an active medical license in Arkansas and possess board certification, along with substantial patient care experience. This opportunity not only allows for professional growth but also contributes to improving healthcare outcomes for patients in need. If you are a dedicated physician looking to make an impact while enjoying the benefits of remote work, this position is perfect for you.

Qualifications

• Active medical license in Arkansas is required.
• Minimum of five years of direct patient care experience.

Responsibilities

• Perform prior authorizations and retrospective reviews for Medicaid.
• Use AFMC ReviewPoint for clinical reviews when indicated.

Skills

Medical Review

Patient Care

Clinical Assessment

Prior Authorization

Education

Medical Degree

Board Certification

Tools

AFMC ReviewPoint

Internet Service

Job description

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Job Title

Job Type: Occasional

Category

Medical Services

Location

Work from Home FSM Based - Fort Smith, AR 72903 US
Work from Home LR Based - Little Rock, AR 72201 US (Primary)

Education

Professional

Travel

Job Description

AFMC is looking to contract with physicians to complete prior authorizations and retrospective reviews. Compensation is paid by review completed.

Specialists Needed:

• Hematologist/Oncologist
• Pulmonologist
• Cardiologist
• Urologist

Scope of Services:

The types of reviews AFMC Clinical Services completes are Medicaid prior authorizations and retrospective reviews.

• Perform assigned initial and reconsideration reviews such as:
  • Prior authorizations for:
  • Durable Medical Equipment, Hyperalimentation, Ventilators, and Wheelchairs
  • Medical/Surgical Procedures and Hyperbaric Oxygen Treatment
  • Physician Administered Drugs
  • Molecular Pathology
• Inpatient Length of Stay
• Emergency Room
• Extension of Benefits
• Hospital Acquired Conditions
• Acute Crisis Unit
• Use AFMC ReviewPoint – a clinical review platform, when indicated.
• Maintain reliable internet with speeds of 2Mbps uploaded to maintain call quality and process integrity. +15Mbps download generally allows more fluid access to data and systems while lower speeds will result in increased lag time. Please note there is nothing AFMC team can do to improve your home internet access. To test your speed, go to www.speedtest.net.
• Additional duties, as agreed upon.

Job Requirements

Credentialing Qualifications:

• Active, unrestricted license to practice medicine in Arkansas
• Board-certified
• Minimum of five (5) years full-time equivalent direct patient care experience
• Direct patient care experience within the previous three (3) years
• Maintain current liability and malpractice insurance coverage for non-UR clinical activities
• Located in a state or territory of the United States when conducting appeal considerations

Internet Requirements:

Reliable, high-speed wireless internet service (Wi-Fi)

Equal Opportunity Employer/Veterans/Disabled EEO IS THE LAW

AFMC, Inc. is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability or any other status protected by federal, state and/or local law. AFMC invites any employee and/or applicant to review the Company’s Affirmative Action Plan. This plan is available for inspection upon request, which may be made in person or by telephone [phone], by fax [phone] or by U.S. mail Attn: Human Resources, 1020 West 4th Street, Suite 400, Little Rock, AR 72201.