On-Site Physician Advisor: Medical Necessity & Denials

Sentara Health; Virginia Beach (VA); On-site; USD 190,000 - 230,000; Full time

Benefits offered by this job

Medical, Dental, Vision plans

Paid Time Off

401k/403B with Employer Match

Tuition Assistance

Student Debt Pay Down

Reimbursement for certifications

Pet Insurance

Job summary

Sentara Health in Virginia Beach, VA is seeking an On-Site Physician Advisor to conduct medical necessity reviews and support denials management for Sentara hospital facilities. The role requires active Virginia medical licensure and board-certified status with at least 3 years of clinical experience.

The Physician Advisor will collaborate with Clinical Revenue Cycle, UR, and hospital leadership, providing guidance on regulatory requirements and documentation integrity to support hospital status

Qualifications

• Active and unrestricted Virginia medical license.
• Board certification in specialty required at time of hire.
• Minimum of 3 years of clinical/hospital experience preferred.

Responsibilities

• Perform timely and compliant medical necessity reviews with clear documentation.
• Facilitate denials management and assist with appeals letters.
• Collaborate with hospital leadership, medical staff and ICM to support initiatives.
• Attend and participate in Hospital UM committees at designated sites.
• Complete training and continuing education as deemed necessary.
• Provide educational presentations to medical staff, administration and peers.

Skills

Interpersonal communication

Regulatory knowledge

Documentation/compliance

Peer-to-peer communication

Education

MD or DO degree

Residency completed

Board certification in specialty

Tools

EMR systems

Hospital billing systems

Job description

Sentara Health in Virginia Beach, VA is seeking an On-Site Physician Advisor to conduct medical necessity reviews and support denials management for Sentara hospital facilities. The role requires active Virginia medical licensure and board-certified status with at least 3 years of clinical experience.

The Physician Advisor will collaborate with Clinical Revenue Cycle, UR, and hospital leadership, providing guidance on regulatory requirements and documentation integrity to support hospital status