State Licensed Physician Advisor

Job Summary

To support client facilities in navigating compliant revenue processes, the full-time remote State Licensed Physician Advisor will review payor peer-to-peer cases, evaluate documentation for authorization denials, and engage with payor medical directors regarding case appropriateness.

Key responsibilities:

• Evaluate authorization requests and associated documentation to determine compliance and appropriateness
• Engage with payor medical directors to discuss authorization status and provide timely responses to inquiries
• Serve as a clinical resource for medical and case management staff, addressing documentation and utilization issues

Required qualifications:

• Active, unrestricted MD or DO medical licensure
• Minimum of 3 years of clinical experience post-residency completion
• Strong clinical knowledge across multiple areas
• Proficiency in basic computer skills
• Ability to work independently in a fast-paced environment