Physician Advisor

Washington & West, LLC; Towson (MD); On-site; USD 150,000 - 200,000; Full time

Job summary

Washington & West, LLC in Towson, Maryland, is seeking self-motivated FT/PT Physician Advisors to join our team. The Physician Advisor will serve as a clinical resource, addressing utilization issues, peer to peer reviews, and hospital reimbursement matters.

Ideal candidates must hold an active MD or DO licensure with at least 3 years of post-residency clinical experience. Strong communication skills, problem-solving abilities, and adaptability to change are essential for success in this dynamic role.

Qualifications

• Active, unrestricted MD or DO medical licensure is required.
• Experience in a clinical environment with sound judgement in clinical documentation.
• Strong computer proficiency necessary.

Responsibilities

• Serve as a clinical resource to medical staff for utilization issues.
• Conduct peer to peer reviews and address hospital reimbursement issues.
• Represent client hospitals in appeals of denied claims.

Skills

Clinical knowledge

Verbal communication

Written communication

Problem-solving

Negotiation

Education

MD or DO medical licensure

3+ years of post-residency experience

Job description

We are a full-service denial and appeals management company that actively pursues
the recovery of funds from health insurance payors who have wrongfully denied
claims, underpaid claims, or who are extremely slow to pay.

Job Description

We’re looking for self‑motivated FT/PT Physician Advisors to join our team.

The Physician Advisor serves as a clinical resource to medical staff by providing identification, facilitation and resolution of utilization issues. The Physician Advisor addresses the following issues: peer to peer reviews, compliance, level of care, length of stay, hospital reimbursement and quality issues for our hospital clients.

The Physician Advisor also serves as an expert on appeals and will represent client hospitals where claims were denied by either governmental contractors or commercial payers. The position will involve a thorough review of patient clinical and hospital course documentation and payer policy and denial information.

Qualifications

Candidates must apply on our website for consideration

A successful candidate must have:

• Active, unrestricted MD or DO medical licensure
• Experience in a clinical environment and the ability to use sound judgment in reviewing clinical documentation supporting patient care.
• At least 3 years of experience post‑residency, clinical practice experience
• Strong clinical knowledge base
• Must be computer proficient
• Strong verbal and written communication skills
• Must be professional, organized and possess persuasive writing and speaking skills
• Possess strong negotiating/reasoning/logic and problem‑solving skills
• Must have the ability to perform case reviews across multiple specialties
• Able to play a dynamic role with ability to adapt to constant change as needs change

Additional Information

All your information will be kept confidential according to EEO guidelines.