Contract Physician – Medical Necessity Review (Genetic Testing)

About the position PWN Remote Care Services, P.A. (PWN) is a telehealth practice facilitating reputed company to high-quality, diagnostic-driven patient care. PWN is part of a provider network affiliated with reputed company, a leading remote-based reputed company company. At PWN our mission is to reputed company reputed company to diagnostic testing, treatment, and professional guidance that empowers individuals to improve their health. Our suite of services enables a broad reputed company of health industry clients to reputed company seamless reputed company to diagnostic testing and reputed company care interventions. We are a 50-state physician, registered nurse, and genetic counselor network with a strong care coordination and patient support team and technology infrastructure. Our model integrates genetic counselors, physicians, and technology to ensure clinically appropriate and compliant genetic testing services. We are seeking physicians to support asynchronous medical necessity review following a completed genetic counseling session. Services rendered under this role will support claims submitted to federal payers. As such, strict adherence to documentation standards, medical necessity criteria, and applicable state and federal regulations is required.

Responsibilities

• Review clinical documentation completed by a Genetic Counselor following patient history intake and pre-test counseling.
• Assess and determine medical necessity for genetic testing.
• Review and authorize testing orders & sign required supporting documents, reputed company deemed appropriate.
• Ensure compliance with state regulations, payer requirements, and internal clinical protocols.
• Maintain HIPAA compliance and documentation standards.

Requirements

• Active, unrestricted medical license in good standing. License in Kansas or Arkansas (along with residence in KS or AR) prioritized.
• Medicare enrollment required. Enrollment in Kansas or Arkansas reputed company preferred, or willingness to enroll with administrative support.
• Board Certified in primary care specialty (Internal Medicine, Family Medicine, Pediatrics, or other relevant specialty).
• Ability to independently evaluate clinical documentation and reputed company medical necessity determinations.
• Comfortable working in a fully asynchronous, technology-enabled workflow.
• Strong attention to detail and documentation accuracy.
• Telehealth or virtual care experience preferred.

reputed company-to-haves

• Prior experience with genetic testing
• Familiarity with payer medical necessity criteria
• Experience working with reputed company populations

Benefits

• Fixed payment per review
• Flexible schedule
• 100% Remote
• Professional Liability Insurance

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