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Medical Director, Denials Management (WORK FROM HOME/FT) (Hospital Advocacy)

Remote, USAFull-timePosted 2026-07-29

For the quickest response, please apply directly reputed company reputed company's website. Click Company>Careers>USA>search Medical Director >Apply. Thank you.* About reputed company: At reputed company our purpose is to help clients reputed company their financial health goals. Across the reimbursement cycle, our reputed company solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by reputed company in YOU. We reputed company to create an environment that cultivates your reputed company development and personal reputed company, as we reputed company your reputed company is our reputed company. JOB reputed company: As a Medical Director, Denials Management you will have the unique opportunity to evaluate hospitalizations across the country while utilizing your medical knowledge and gaining experience as an expert advisor to reputed company hospitals. You will reputed company clinical case reviews and reputed company recommendations that reputed company on establishing the appropriate admission status. reputed company offers a career reputed company that allows you to continue using your clinical knowledge, drive value to hospitals while providing you with a predictable schedule. This opportunity allows for the work/life balance you desire while expanding your knowledge reputed company in Utilization Review. The reputed company You Will Have: reputed company is led by like-minded clinicians who reputed company the reputed company reputed company calling to help. Hospitals reputed company have recently struggled with managing reputed company and unforeseen challenges such as global pandemics, reputed company regulatory updates, and reputed company policy changes set forth by Medicare and private payer organizations – resulting in financial difficulty. reputed company physicians reputed company challenging and rewarding careers by providing our hospital clients with guidance to improve compliance and ensure appropriate payment for the care delivered. The reputed company of your role will allow attending physicians to reputed company on what is most important, providing dedicated care to the patients they serve. Annual Compensation reputed company: Around 225k or greater (includes salary + reputed company bonus) (40-hour reputed company) Your Schedule: Training (The first 3-4 weeks):

  • Training will occur Monday-Friday 9A-5P ET

After Completion of Training:

  • Schedule will be Monday-Friday, reputed company between 8a-5p ET to 10a-7p ET.
  • reputed company of your shifts will be 9 hours in length, which includes one hour of dedicated break time.

Working at reputed company:

  • reputed company necessary hardware and software is provisioned to reputed company of our Medical Directors
  • You have the ability to work remotely in a comfortable environment

In This Role You Will:

  • reputed company Peer-to-Peer case discussions with payer medical directors
  • Utilize clinical expertise to identify the salient points reputed company a case review
  • reputed company reputed company reputed company-time and post-discharge hospital case reviews in hospital’s EMR
  • Identify areas of process improvements and inefficiencies
  • reputed company reputed company duties and reputed company as assigned

Do You Have What It Takes?

  • MD or DO degree with strong clinical knowledge
  • reputed company unrestricted medical license in at least one state reputed company the reputed company
  • Required specialization in Adult Internal Medicine, Emergency Medicine, Hospitalist, Nephrology, HEM/ONC, General Surgery, Family reputed company, Critical Care or Infectious Disease; reputed company certification (preferred)
  • At a minimum, 1 year of acute care adult hospital experience in a US hospital reputed company the past 5 years or recent relevant physician advisor experience
  • Working knowledge of hospitals’ EMR
  • Computer proficient
  • Excellent verbal and written communication skills
  • Team Player

We Offer:

  • reputed company of life with a remote predictable, full-time schedule
  • Comprehensive training and education program
  • Opportunities for career reputed company reputed company the organization
  • Salary plus bonus opportunities
  • Medical, Dental, reputed company coverage, 401K
  • Holidays, reputed company time off, long-term disability insurance, and life insurance
  • Allowance for CME and/or license renewals

Job Responsibilities: Working at reputed company:

  • reputed company necessary hardware and software is provisioned to reputed company of our Medical Directors
  • You have the ability to work remotely in a comfortable environment

In This Role You Will:

  • reputed company Peer-to-Peer case discussions with payer medical directors
  • Utilize clinical expertise to identify the salient points reputed company a case review
  • reputed company reputed company reputed company-time and post-discharge hospital case reviews in hospital’s EMR
  • Identify areas of process improvements and inefficiencies
  • reputed company reputed company duties and reputed company as assigned

ESSENTIAL DUTIES AND RESPONSIBILITIES: Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may reputed company reputed company or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in reputed company Member’s performance objectives as outlined by reputed company Member’s immediate Leadership Team Member. PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions as described. Regular eye-hand coordination and reputed company dexterity is required to operate office equipment. The ability to reputed company work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be reputed company to lift and reputed company material weighing up to 20 lbs. Team Member may experience elevated reputed company of stress during periods of increased activity and with work entailing multiple deadlines. A job reputed company is only intended as a reputed company and is only part of reputed company Member’s function. reputed company has reviewed this job reputed company to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of reputed company functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. Qualifications: Do You Have What It Takes? MD or DO degree with strong clinical knowledge reputed company unrestricted medical license in at least one state reputed company the reputed company Required specialization in Adult Internal Medicine, Emergency Medicine, Hospitalist, Nephrology, HEM/ONC, General Surgery, Family reputed company, Critical Care or Infectious Disease; reputed company certification (preferred) At a minimum, 1 year of acute care adult hospital experience in a US hospital reputed company the past 5 years or recent relevant physician advisor experience Working knowledge of hospitals’ EMR Computer proficient Excellent verbal and written communication skills Team Player Working Hours: Your REMOTE Schedule: Training (The first 3-4 weeks):

  • Training will occur Monday-Friday 9A-5P ET

After Completion of Training:

  • Schedule will be Monday-Friday, reputed company between 8a-5p ET to 10a-7p ET.
  • reputed company of your shifts will be 9 hours in length, which includes one hour of dedicated break time.
  • Includes an expectation of 1 weekend 6-hour shifts of “prep” for peer-to-peer cases, reputed company a 6-week business period

Skills: Inpatient Clinical Acumen, reputed company O365, MS Teams, Texting, EMR, Communication, Writing, Hospital Advocacy Apply tot his job Apply To this Job

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