External Physician Reviewer

About the role

AFMC is seeking contracted physicians to perform prior authorizations and retrospective reviews from home using a laptop or desktop computer. Compensation is based on the number of reviews completed.

Specialists Needed

• Hospitalist
• ENT
• Pulmonologist
• Neurologist
• Gastroenterologist
• Geneticist
• Nephrologist
• Oncologist
• OB/Gyn
• Oral Surgeon

Scope of Services

The services provided by AFMC Clinical Services include Medicaid prior authorizations and retrospective reviews. Specific tasks include:

• Perform assigned initial and reconsideration reviews such as:
• Prior authorizations for:
• Durable Medical Equipment, Hyperalimentation, Ventilators, and Wheelchairs
• Medical/Surgical Procedures and Hyperbaric Oxygen Treatment
• Retrospective reviews for:
• Inpatient Length of Stay
• Emergency Room
• Extension of Benefits
• Hospital Acquired Conditions
• Acute Crisis Unit
• Use AFMC ReviewPoint – a clinical review platform
• Maintain reliable internet with speeds of 2Mbps uploaded to ensure call quality and process integrity. +15Mbps download generally allows for more fluid access to data and systems, while lower speeds may result in increased lag time. To test your speed, visit www.speedtest.net.
• Additional duties, as agreed upon.

Requirements

• Credentialing Qualifications:
• Active, unrestricted license to practice medicine in Arkansas
• Board-certified
• Minimum of five (5) years full-time equivalent direct patient care experience
• Direct patient care experience within the previous three (3) years
• Maintain current liability and malpractice insurance coverage for non-UR clinical activities
• Located in a state or territory of the United States when conducting appeal considerations
• Internet Requirements:
• Reliable, high-speed wireless internet service (Wi-Fi)