Medical Services Specialist

3 weeks ago

Fort Smith, Arkansas, United States Arkansas Foundation for Medical Care Full time
Job Title: Medical Services Specialist

At Arkansas Foundation for Medical Care, we are seeking a Medical Services Specialist to join our team. As a Medical Services Specialist, you will be responsible for completing prior authorizations and retrospective reviews for physicians. This is a contract position that offers a unique opportunity to work with a reputable organization in the medical services industry.

Scope of Services:
The Medical Services Specialist will be responsible for performing initial and reconsideration reviews for prior authorizations and retrospective reviews. This includes reviewing medical records, conducting research, and making recommendations for approval or denial of services.

Responsibilities:
- Review medical records and conduct research to determine the appropriateness of services
- Make recommendations for approval or denial of services
- Collaborate with physicians and other healthcare professionals to ensure accurate and timely reviews
- Maintain accurate and detailed records of reviews and recommendations

Requirements:
- 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

Internet Requirements:
Reliable, high-speed wireless internet service (Wi-Fi)

AFMC is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability or any other status protected by federal, state and/or local law.

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