Medical Director

This is a fully remote position, open to applicants in Maryland.

📋 Description

• Act as a representative for RELI Group and its partners in relation to federal contracts.

• Aid in the prevention of fraud.

• Offer clinical guidance to coding professionals.

• Address inquiries and resolve intricate medical record challenges during contract execution.

• Engage in work group meetings, delivering clinical insights and guidance.

• Function as a clinical subject matter expert.

• Attend and participate in all contractor meetings.

• Conduct research to provide valuable input and support for various contracts.

• Create research documents to enhance educational resources.

• Deliver clinical and coding training to contract personnel as required.

⛳️ Requirements

• Possession of a Graduate Degree.

• Hold a Doctor of Medicine or Doctor of Osteopathy Degree.

• Maintain a current, active, valid, and unrestricted medical license in at least one US state.

• No prior sanctions or exclusions from the Medicare program.

• Board certified as a physician in a specialty recognized by the American Board of Medical Specialties for a minimum of 3 years.

• At least three years of experience in practicing medicine as a board-certified physician.

• In-depth understanding of Medicare and Medicaid payment, coverage, and coding policies.

• Competence in interpreting clinical documentation and resolving disputes related to clinical guidelines.

• Experience in the health insurance sector, a utilization review firm, or another healthcare claims processing organization in a compliance-related role.

• Familiarity with interpreting HCPCS/CPT codes and coding conventions.

• Advanced knowledge of healthcare and healthcare research.

• Ability to work collaboratively with all levels within the contract.

• Exceptional written and verbal communication skills.

• Coding experience or certification is preferred.

🏝️ Benefits

• Additional benefits offered by RELI Group.

• Equal Employment Opportunity / Affirmative Action employer.

• HUBZone candidates are encouraged to apply.