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Clinical Consultant
3 months ago
Medavie Blue Cross has been a prominent health and wellness partner in Canada for over 75 years, dedicated to enhancing community health and addressing healthcare challenges. They are seeking a Medical Consultant to become a part of their Medicare Programs Team on a part-time basis. This position is essential for supporting the post-payment monitoring functions and working closely with key stakeholders to formulate policies and procedures related to monitoring.
Key Responsibilities:- Assist a team of Medicare Auditors in executing billing audits
- Assess alternative funding agreements and contribute to the development of audit plans
- Engage with providers, government bodies, and other stakeholders to discuss audit outcomes
- Offer billing guidance to the audit team and physicians, while also facilitating physician education on fee codes and guidelines
- Coordinate with various departments and assist physicians in appealing billing audits
- Uphold confidentiality and professionalism in all communications
A university degree in medicine, an active medical license, and 10-15 years of experience as a physician are required. Strong communication skills, proficiency in computer applications, and the ability to travel within the region are essential.
Core Competencies:Demonstrated knowledge of industry best practices, analytical thinking, effective communication, customer orientation, organizational skills, and teamwork are crucial for success in this role.
