Licensed Medical Director

Job Summary

To support the Clinical and Coding Audit team, the remote Licensed Medical Director will provide physician-level reviews of short-stay inpatient claims to ensure accurate billing, collaborating with clinical and operational teams while maintaining proficiency in required software.

Key responsibilities:

• Provide physician-level review and determination of short-stay inpatient claims for accurate billing status
• Support audit integrity by delivering clear clinical rationale and partnering with clinical and operational teams
• Collaborate with operational and business partners to drive consistent review outcomes

Required qualifications:

• MD or DO with an active, unrestricted medical license in the U.S
• Current Board Certification in an ABMS or AOBMS specialty
• 3+ years of clinical practice experience
• Technical proficiency in computer software and systems
• Proven ability to work collaboratively in a matrixed environment