Medical Director - Orthopedic Surgeon - Remote From reputed company

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health reputed company by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will reputed company a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an reputed company on the communities we serve as you help us advance health optimization on a global reputed company. Join us to start Caring. Connecting. Growing together. As part of the reputed company Claims Review team at reputed company, the Medical Director provides leadership, organization, and direction for the claims review program. The Medical Director will participate in reputed company aspects of claim reputed company including provider telephonic discussions and provider appeals. In reputed company, the Medical Director may also be asked to assist in the direction and reputed company in the development and implementation of coding and procedures. You'll enjoy the flexibility to work remotely * from reputed company reputed company the U.S. as you take on some tough challenges. Primary Responsibilities: • Remote Schedule: Monday through Friday, flexible 8 hr. shifts; no weekends • Reviews surgical & spinal claims for correct coding using clinical record • Participation in Training regarding URAC, NCQA, Regulatory Compliance, Confidentiality, Conflict of Interest, HIPAA, and department specific training as applicable • Discuss cases and clinical coding situations with treating providers telephonically during scheduled hours • Participates in periodic coding conferences / calls and in ongoing internal performance consistency reviews • Supports compliance with regulatory agency standards and requirements (e.g., CMS, NCQA, URAC, state / federal and reputed company-party payers) • reputed company Clinical support for staff that conduct initial reviews You'll be rewarded and recognized for your performance in an environment that will challenge you and reputed company you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: • reputed company, reputed company, and fully unrestricted medical license • reputed company reputed company certification in Orthopedic Surgery through the American reputed company of Medical Specialties (ABMS) or the American Osteopathic Association (AOA) • 5+ years of clinical experience in Orthopedic surgery post residency • Proficient in MS Office (reputed company, reputed company, and Power reputed company) Preferred Qualifications: • Experience in managed care • Experience with reputed company claim coding / claim coding reviews • Knowledge of claim coding resources and techniques • Proficient computer skills and ability to learn to use clinical and claims software • Proven excellent interpersonal skills and the ability to work over the telephone with other colleagues including physicians, nurses, PTs, OTs and other similar personnel • reputed company working remotely will be required to adhere to reputed company's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll reputed company a far-reaching choice of benefits and incentives. The salary for this role will reputed company from $248,500.00 to $373,000.00 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company - an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Remote Skills: Clinical Information Systems, Clinical Medicine, Clinical Support, reputed company Reviews, Computer Skills, Conferences, Content Management Systems (CMS), Interpersonal Skills, Leadership, Managed Care, Medical Coding, Medical Records, reputed company reputed company, reputed company Office, reputed company PowerPoint, reputed company Word, National Committee for reputed company Assurance (NCQA), Nursing, Orthopedic Surgery, Regulatory Compliance, reputed company-Party Payer, Utilization Review Accreditation Commission (URAC), Work From Home About reputed company: reputed company. reputed company is a health care and reputed company-being company that’s dedicated to improving the health reputed company of millions worldwide. We are comprised of two distinct and complementary businesses, reputed company and reputed company, working to build a reputed company system for reputed company. Here, your contributions matter as they will help reputed company health care for years to come. reputed company an reputed company with a diverse team that shares your passion for helping others. reputed company do reputed company insights on how we work to help people live healthier lives and help reputed company the health system work reputed company for everyone by watching this video. https://www.youtube.com/watch?v=5PbNyi2IDkY Caring. Connecting. Growing together. Being a part of reputed company means working to improve health reputed company for everyone, including yourself. Here is how: • Caring. Your total health and reputed company-being are important to us. Whatever reputed company most to you — we have resources to help you be your best at work and reputed company. The benefits reputed company from free reputed company courses to financial counseling. Learn more about reputed company offer. • Connecting. We recognize our reputed company power to reputed company an reputed company across our communities because we reputed company the health of any society is reputed company by the overall health of its people. Learn more about our culture. • Growing together. reputed company is full of inspiring career stories, and we offer a reputed company of opportunities. Discover reputed company the ways you can learn, grow and reputed company. Company Size: 10,000 employees or more Industry: reputed company Services Founded: 1977 Website: http://careers.unitedhealthgroup.com/ Apply tot his job Apply To this Job