Everlywell
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, when deemed appropriate.
- Ensure compliance with state regulations, payer requirements, and internal clinical protocols.
- Maintain HIPAA compliance and documentation standards.
Qualifications
- 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 Medicaid 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 render 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.
Ideal Experience
- Prior experience with genetic testing
- Familiarity with payer medical necessity criteria
- Experience working with Medicaid populations
Benefits
- Fixed payment per review
- Flexible schedule
- 100% Remote
- Professional Liability Insurance
Originally posted on Himalayas
To apply for this job please visit himalayas.app.
Working in United States
The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic consisting of 50 states and a federal capital district, Washington, D.C. The 48 contiguous states border Canada to the north and Mexico to the south, with the semi-exclave of Alaska in the northwest and the archipelago of Hawaii in the Pacific Ocean. The United States also asserts sovereignty over five major island territories and various uninhabited islands in Oceania and the Caribbean. It is a megadiverse country, with the world's th
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