Regional Physician Advisor Position (Southeast) Coastal Virginia Near the Beach

Sentara Hospitals•Norfolk, VA

7h•Onsite

About The Position

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

Responsibilities

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.
Interface with hospital and medical staff leadership.
Facilitate communication between Revenue Cycle leadership and processes and the hospital facilities.
Champion processes and initiatives.
Assist with both formal and informal education of medical staff at Sentara hospital facilities.
Support and meet the Clinical Revenue Cycle functions organizational goals and objectives for assuring the effective, efficient utilization of health care services.

Benefits

Medical, Dental, Vision plans
Adoption, Fertility and Surrogacy Reimbursement up to $10,000
Paid Time Off and Sick Leave
Paid Parental & Family Caregiver Leave
Emergency Backup Care
Long-Term, Short-Term Disability, and Critical Illness plans
Life Insurance
401k/403B with Employer Match
Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
Student Debt Pay Down – $10,000
Reimbursement for certifications and free access to complete CEUs and professional development
Pet Insurance
Legal Resources Plan
Annual discretionary bonus if established system and employee eligibility criteria is met