Medical Director - Denials Management

Versalus Health - Newtown Square, PA5.0

Full-timeEstimated: $180,000 - $230,000 a year
SkillsBenefits

Position Type: Full Time

Office Location: Onsite positions in Newtown Square and/or remote opportunities

Versalus Health is an innovative, rapidly growing physician-led organization that provides hospitals with next-generation solutions focused on the intersection of utilization management, revenue cycle, and compliance. The company has a vibrant culture that strives to promote a positive work/life balance while allowing physicians to utilize their clinical skills in an environment that positively impacts healthcare. Versalus’ Medical Directors collaborate on teams and share their medical expertise while educating hospital clients. Come be a part of the Versalus team and positively change healthcare!

Job Description: Medical Director

The Medical Director acts as an expert resource to client hospitals by providing case reviews in real-time, a methodology for change in admission status, a structure for submission of clinical information to the payors, and a defense of the hospital stay if needed.

Job Responsibilities:

  • Perform focused real-time case reviews with full access to EMR and an emphasis on full record review.
  • Promote hospital efficiency through better communication between departments.
  • Determine the salient features of a hospital stay.
  • Create problem lists from the records to show specific hospital services provided.
  • Provide in-depth clinical experience with clear and concise documentation.
  • Interact with attending physicians at client hospitals by text or telephone.
  • Perform Peer-to-Peer case discussions with payor medical directors.
  • Additional responsibilities available with growth of the company.

Skills:

  • Strong clinical knowledge
  • Good communication skills
  • Team Player
  • Collaborative
  • Computer proficient
  • Good problem solver
  • Organized
  • Professional

Education/Experience Required:

  • MD or DO
  • Peer to Peer experience
  • Current or recent inpatient hospital experience
  • Medical degree and post-graduate medical training from accredited clinical programs
  • Board certification preferred
  • Previous physician advisor and/or medical director experience helpful, but not necessary

Physical Requirements:

May be expected to sit at a desk for long hours. Repetitive movement of hands and fingers – typing and/or writing. Occasional standing, walking, stooping, kneeling or crouching. Ability to reach with hands and arms, talk and hear. Exert up to 20 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.

Job Type: Full-time

Job Type: Full-time

Experience:

  • Hospital: 1 year (Preferred)

License:

  • MD/DO (US license required) (Required)

Benefits offered:

  • Paid time off
  • Health insurance
  • Dental insurance
  • Retirement benefits or accounts

This job will require you to pass a background check:

  • Yes