Brundage Medical Group LLC - Physician Advisor M-F

Brundage Medical Group LLC - Physician Advisor M-F In order to use this site, it is necessary to enable JavaScript. Here are the instructions how to enable JavaScript in your web browser. All Jobs  >  Physician Advisor M-F Brundage Medical Group LLC Apply Physician Advisor M-F Fully Remote • Largo, FL Apply Description  Brundage Group provides revenue cycle solutions and physician advisory services that empower hospitals nationwide to capture earned revenue, ensure compliance, and improve operational efficiency. We blend clinical thought leadership with cutting-edge technology to help hospitals stay viable to continue serving our communities.   The Physician Advisor (PA) will drive quality performance across the organization by communicating with hospital physicians, utilization management, case management, CDI, the denials team, and quality staff. The PA conducts case reviews to ensure compliance, appropriate and accurate clinical documentation, and appropriate utilization of health care services. The PA will meet with hospital personnel and medical staff when needed to provide education and expertise. The PA acts as a consultant and resource for attending physicians regarding appropriate status, utilization of resources, need for continued hospitalization, compliance concerns and tracking and reporting of quality and complications. The PA will also interact with medical directors of third-party payers to discuss the medical necessity, utilization of resources and appropriate level of care.  Requirements   Utilization Management Functions  - Reviews medical records of patients identified by the UM team or as requested by the healthcare team  - Perform status determinations including 2nd level reviews and continued stay reviews for traditional Medicare patients and all other payors  - Review Code 44 cases  - Assist with length of stay management  - Work with case management and the interdisciplinary team to ensure appropriate continuity of care and reduce readmissions  - Communicate with the medical staff through secure email, secure texting applications, phone calls and face to face interactions to relay important information and provide education  - Act as a liaison between Utilization Management/Case Management and providers to collaborate on appropriate plans of care  - Review and suggest improvements related to resource allocation  - Optimize coordination of care processes  - Provide guidance to ED Physicians and the UM/CM team regarding alternatives to acute care   CDI Functions  - Review documentation for clinical validity of diagnoses  - Support query response and query construction  - Educate physicians on documentation best practices  - Provide feedback to clinical providers   - Assist with pre-bill DRG   Quality Functions  - Review documentation to support quality metrics  - Educate providers on how quality is tracked and common pitfalls    - Review PSIs for appropriate assignment of complications  Denials Management Functions  - Review denials and author appeal letters as needed  - Perform peer to peers with payors  - Act as a liaison with payors to facilitate approvals and prevent denials or carved out days when appropriate   KNOWLEDGE, SKILLS, AND ABILITIES: Abilities may be accessed through written, verbal, and other evaluation methods.   - Expertise in Utilization Management preferred  - Strong interpersonal skills  - Excellent written and verbal communication skills  - Ability to work independently  - Ability to build relationships with key hospital team members    WORK EXPERIENCE, EDUCATION AND CERTIFICATIONS: List preferred/required work experience, education, and certifications  MD or DO  Current, unrestricted medical license in state of residence  Demonstrated ability to build rapport with medical staff and hospital leadership  Strong computer skills and working knowledge of EMRs  Prior Physician Advisor experience or at least 3 years of clinical experience in a hospital-based setting  Preferred Qualifications:  - Board Certified / Eligible  - CCDS or CDIP  - CCS  - CHCQM certification (ABQAURP)   WORKING CONDITIONS AND PHYSICAL REQUIREMENTS:     Conditions typically associated with an office environment.  While performing the essential duties and   responsibilities, the employee is regularly required to talk or hear.  May be frequently required to sit, stand or   walk.  Moderate to prolonged reading, typing, and computer work.  Ability to perform tasks involving physical   activity that may include lifting 25 pounds.  Subject to exposure to all environmental hazards associated with  healthcare and office work.  Apply View All Jobs Powered by Payroll & HR Software