Physician, Inpatient Denials Management (FT/M-F/REMOTE)

📋 Description

• • CorroHealth is seeking a dedicated and experienced Physician, Inpatient Denials Management to join our remote team. This full-time, Monday-Friday role offers a unique opportunity to leverage your extensive medical knowledge and clinical expertise in a non-traditional, impactful capacity. As a Physician, Denials Management, you will play a crucial role in evaluating hospitalizations nationwide, acting as an expert advisor to our client hospitals. Your primary focus will be on conducting thorough clinical case reviews and providing strategic recommendations to ensure the appropriate admission status is established, directly impacting hospital financial health and operational efficiency.
• • This position is ideal for physicians who are looking to transition into a role that offers a predictable schedule and a healthy work-life balance, while still utilizing their clinical acumen. You will gain invaluable experience in Utilization Review and contribute significantly to improving hospital compliance and securing appropriate reimbursement for delivered care. Our leadership team comprises like-minded clinicians who are driven by a shared purpose: to help healthcare providers overcome complex financial challenges.
• • Hospitals across the country are navigating a landscape fraught with difficulties, including global pandemics, evolving regulatory mandates, and shifting payer policies. These challenges often lead to significant financial strain. CorroHealth physicians are at the forefront of addressing these issues, providing essential guidance that enhances compliance and ensures that hospitals are appropriately compensated for the high-quality care they provide. Your work will empower attending physicians to dedicate their full attention to patient care, knowing that the administrative and financial aspects of their services are being expertly managed.
• • Success in this role hinges on strong foundational computer skills and the ability to quickly adapt to new digital platforms, as our workflows are integrated across multiple systems. You will be responsible for performing peer-to-peer case discussions with payer medical directors, articulating the clinical rationale behind admission decisions and advocating for appropriate patient status. This requires a deep understanding of medical necessity criteria and payer guidelines.
• • You will conduct focused, real-time, and post-discharge hospital case reviews directly within the hospital's Electronic Medical Record (EMR) system. This involves meticulously analyzing patient charts, treatment plans, and clinical documentation to identify key information and potential areas of concern. Your clinical expertise will be paramount in discerning the salient points within each case, ensuring that all relevant medical information is accurately assessed.
• • A significant aspect of this role involves identifying opportunities for process improvements and efficiencies within the hospital's utilization review and denials management workflows. You will collaborate with hospital staff to implement best practices and streamline operations, ultimately reducing claim denials and improving revenue cycle performance. This proactive approach to problem-solving is critical to our clients' success.
• • The role also encompasses performing related duties and participating in special projects as assigned, allowing for continuous learning and professional development. CorroHealth is committed to fostering a supportive environment where physicians can build long-term careers. We invest in your professional development and personal growth, recognizing that your success is intrinsically linked to our own. You will be provided with all necessary hardware and software, and the flexibility to work remotely from a comfortable environment.
• • The annual compensation for this position is competitive, ranging around $225,000 or greater, which includes a base salary plus an uncapped bonus structure, reflecting the significant impact and responsibility of the role. The standard workweek is 40 hours. During the initial 3-4 weeks of comprehensive training, the schedule will be Monday-Friday, 9 AM to 5 PM ET. Upon successful completion of training, your schedule will be flexible, Monday-Friday, between 8 AM and 7 PM ET, with each shift being 9 hours long, including a dedicated hour for breaks. This structure ensures a consistent and manageable workload, promoting a sustainable career path.