Physician advisors are physicians who perform case reviews to evaluate previous actions and determine whether to confirm the initial physician findings and recommendations. They are generally employed by hospitals and other medical facilities, and conduct these reviews in situations where an admission or procedure may have received an initial denial from an insurance provider. They may also conduct reviews to ensure compliance with various healthcare regulations. They often serve as a liaison between various hospital teams and personnel, including administrators, doctors, and patient advocates.
Physician advisors are typically an M.D. or D.O. with a broad range of clinical experience, and must have a valid license to practice medicine in their state. They often have a background in physician leadership or hospital administration, and must be well-versed in insurance policies and regulations.
Average Years of Experience
Common Skill Sets