Sentara Health is seeking to hire a qualified individual to join our team as Regional Physician Advisor.

Position Status: Full-time, Day Shift

Position Location: On-site.

Standard Working Hours: 8:00AM to 5:00PM (ET).

Sentara Health is seeking to hire a qualified individual to join our team as Regional Physician Advisor.

Expectations for this Role:

The Regional Physician Advisor supports the Clinical Revenue Cycle’s Utilization Review and Denials/Appeals processes to determine and secure appropriate level of care assignments to ensure compliant billing, assist with denials management, support documentation integrity as it pertains to accurate coding capture. The Regional Physician Advisor interfaces with hospital and medical staff leadership, facilitating communication between Revenue Cycle leadership and processes and the hospital facilities and championing processes and initiatives. The Regional Physician Advisor assists with both formal and informal education of medical staff at Sentara hospital facilities. This role is responsible for supporting and meeting the Clinical Revenue Cycle functions organizational goals and objectives for assuring the effective, efficient utilization of health care services.

Requirements:

Completion of Medical doctorate or Doctor of Osteopathy degree from an accredited medical school
• Completion of an accredited residency training program
• Minimum of 5 years of clinical experience, hospital clinical experience strongly preferred
• Minimum of 2 years of physician advisory experience strongly preferred
• Active and unrestricted state Virginia medical license
• Board certification in specialty required at time of hire
• Posess or acquire a thorough understanding of CMS regulatory guidance and requirements as they pertain to UR and site of service decisions
• Possess a working knowledge of clinical documentation integrity, hospital billing and coding processes and guidelines, case mix index, and DRG assignments.
• Familiarity with standard published leveling criteria such as MCG/Interqual and ability to apply professional judgment and patient specific variables as may be necessary or justifiable.
• Familiarity with (Hospital) organization and case management operations
• Excellent customer service and interpersonal skills.
• Able to effectively present information, both formal and informal
• Superb written and verbal communications skills
• Strong organizational and analytic skills, and ability to set and manage priorities
• Demonstrate flexibility, teamwork, and a collaborative leadership style
• Strong technical/computer skills and working knowledge of the system’s EMR
• Ability to provide a consistent on-site presence at assigned sites

#indeed