Physician Advisor

Job description

Accountabilities: Review complex clinical cases, medical records, and payer determinations to support denial management, appeals, and reimbursement decisions. Provide physician-level guidance on medical necessity, appropriateness of care, and utilization management processes. Collaborate with revenue cycle teams, case managers, and clinical staff to improve documentation and reduce preventable denials. Support appeals processes by delivering clinical justification and communicating with payers and internal stakeholders. Analyze trends in denials and utilization to identify opportunities for process improvement and clinical optimization. Contribute to the development and refinement of clinical and revenue cycle policies to align with payer requirements and regulatory standards. Serve as a subject matter expert in clinical documentation improvement and revenue integrity initiatives. Requirements: MD or DO degree with active board certification in a clinical specialty. Active medical license in good standing in the United States. Strong understanding of hospital revenue cycle processes, utilization review, and payer requirements. Experience in clinical documentation improvement, case review, or utilization management strongly preferred. Ability to interpret complex clinical data and translate it into payer-compliant documentation and appeals. Excellent communication skills with the ability to collaborate across clinical and administrative teams. Strong analytical thinking and ability to identify trends and systemic improvement opportunities. Experience working in healthcare systems, hospital settings, or managed care environments is a plus. Benefits: Competitive compensation aligned with clinical expertise and experience Comprehensive medical, dental, and vision insurance Retirement savings plan with employer contributions Paid time off, holidays, and flexible work arrangements (remote eligible) Professional development and continuing education support Life and disability insurance coverage Opportunity to influence system-wide clinical and financial improvements Mission-driven environment focused on improving healthcare access and outcomes Inclusive workplace culture with strong emphasis on collaboration and respect. How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best! Why Apply Through Jobgether? Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time. #LI-CL1 This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Physician Advisor in the United States. This role plays a critical part in bridging clinical expertise with revenue cycle performance, ensuring that medical necessity, utilization management, and clinical documentation align with payer requirements and regulatory standards. You will serve as a trusted clinical expert supporting denial management, appeals, and complex case reviews across hospital systems. The position requires close collaboration with revenue cycle teams, physicians, and administrative stakeholders to improve reimbursement outcomes and reduce avoidable revenue loss. You will contribute to the optimization of clinical and financial workflows by providing physician-level insights into case reviews and payer determinations. This is a high-impact role where clinical judgment directly supports operational efficiency and organizational financial health. It is ideal for a physician who enjoys influencing systems-level improvements beyond direct patient care.