Contract Physician – Medical Necessity Review (Genetic Testing)

TL;DR

Contract Physician (Medical Necessity Review - Genetic Testing): Review clinical documentation from genetic counselors post patient intake and pre-test counseling to assess and authorize genetic testing orders with an accent on medical necessity determination, payer compliance, and regulatory standards. Focus on evaluating documentation independently, signing orders when appropriate, and maintaining strict adherence to HIPAA, state, and federal guidelines.

Location: 100% Remote (US; active unrestricted medical license required, Kansas or Arkansas prioritized along with residence in KS or AR; Medicare enrollment required)

Company

Telehealth practice enabling access to diagnostic testing and care, part of hirify.global's 50-state provider network with genetic counselors, physicians, and technology infrastructure.

What you will do

• Review genetic counselor documentation following patient history intake and pre-test counseling.
• Assess medical necessity for genetic testing and authorize orders when appropriate, signing supporting documents.
• Ensure compliance with state regulations, payer requirements, federal guidelines, and internal protocols.
• Maintain HIPAA compliance and high documentation standards in an asynchronous workflow.

Requirements

• Active, unrestricted US medical license in good standing; license and residence in Kansas or Arkansas prioritized
• Medicare enrollment required; Kansas or Arkansas Medicaid enrollment preferred or willingness to enroll with support
• Board Certified in primary care specialty (Internal Medicine, Family Medicine, Pediatrics, or relevant)
• Ability to independently evaluate clinical documentation and render medical necessity decisions
• Comfortable with fully asynchronous, technology-enabled telehealth workflow
• Strong attention to detail and documentation accuracy

Nice to have

• Prior experience with genetic testing
• Familiarity with payer medical necessity criteria
• Experience working with Medicaid populations
• Telehealth or virtual care experience

Culture & Benefits

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