Contract Physician – Medical Necessity Review (Genetic Testing)
Everly Health · United States
What the posting says
Each fact was read from this posting and checked:Statedin the posting, quotedConflictsposted two ways, both shownNot mentionedwe looked; it is not there
- Employment typeStated
- Contractor
- Work arrangementStated
- Remote OK
- ShiftStated
- variable
- Flexible schedule
from the posting - EducationStated
- ['professional certificate']
Not mentioned in this posting
We read the whole posting. These are not in it. Not a no: ask the recruiter, in your own words.
- PayNot mentioned
- The posting does not say
- ExperienceNot mentioned
- The posting does not say
- Visa sponsorshipNot mentioned
- The posting does not say
Requirements, each with its sentence from the posting
These are the employer’s words. The index does not judge whether you meet them.
- Active unrestricted medical licenserequired
Active, unrestricted medical license in good standing
from the posting - Board certification in primary carerequired
Board Certified in primary care specialty (Internal Medicine, Family Medicine, Pediatrics, or other relevant specialty)
from the posting - Medicare enrollmentrequired
Medicare enrollment required
from the posting - Medical necessity evaluationrequired
Ability to independently evaluate clinical documentation and render medical necessity determinations
from the posting - HIPAA compliance knowledgerequired
Maintain HIPAA compliance and documentation standards
from the posting - Documentation accuracyrequired
Strong attention to detail and documentation accuracy
from the posting - Telehealth or virtual care experiencepreferred
Telehealth or virtual care experience preferred
from the posting - Kansas or Arkansas licensurepreferred
License in Kansas or Arkansas (along with residence in KS or AR) prioritized
from the posting - Medicaid enrollment in KS or ARpreferred
Enrollment in Kansas or Arkansas Medicaid preferred, or willingness to enroll with administrative support
from the posting - Genetic testing experienceimplied
Prior experience with genetic testing
from the posting - Payer medical necessity criteria familiarityimplied
Familiarity with payer medical necessity criteria
from the posting - Medicaid population experienceimplied
Experience working with Medicaid populations
from the posting
Read the full posting as the employer wrote it
Responsibilities
- Review clinical documentation completed by a Genetic Counselor following patient history intake and pre-test counseling.
- Assess and determine medical necessity for genetic testing.
- Review and authorize testing orders & sign required supporting documents, when deemed appropriate.
- Ensure compliance with state regulations, payer requirements, and internal clinical protocols.
- Maintain HIPAA compliance and documentation standards.
Qualifications
- Active, unrestricted medical license in good standing. License in Kansas or Arkansas (along with residence in KS or AR) prioritized.
- Medicare enrollment required. Enrollment in Kansas or Arkansas Medicaid preferred, or willingness to enroll with administrative support.
- Board Certified in primary care specialty (Internal Medicine, Family Medicine, Pediatrics, or other relevant specialty).
- Ability to independently evaluate clinical documentation and render medical necessity determinations.
- Comfortable working in a fully asynchronous, technology-enabled workflow.
- Strong attention to detail and documentation accuracy.
- Telehealth or virtual care experience preferred.
Ideal Experience
- Prior experience with genetic testing
- Familiarity with payer medical necessity criteria
- Experience working with Medicaid populations
Benefits
- Fixed payment per review
- Flexible schedule
- 100% Remote
- Professional Liability Insurance
The posting text is reproduced as the employer wrote it; the index adds nothing to it.