Minnesota Licensed Medical Director
Job Summary
To lead the claims review program, the remote Minnesota Licensed Medical Director in General Surgery will manage surgical and professional claim reviews, ensure compliance with regulatory standards, and collaborate with healthcare providers while working from anywhere in the U.S.
Key responsibilities:
- Reviews surgical and professional claims for correct coding using clinical records
- Participates in provider discussions and clinical coding training sessions
- Composes clinical summaries and rationales for medical necessity decisions as needed
Required qualifications:
- Current, active, and fully unrestricted medical license
- Current board certification in General Surgery through ABMS or AOA
- 5+ years of clinical experience with brain and spine surgeries post-residency
- Proficiency in MS Office (Word, Excel, PowerPoint)
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