Medical Reviewer, Physician Assistant

This a Full Remote job, the offer is available from: United States Opportunity Overview: We are looking for an orthopedic spine Physician Assistant to help deliver on reputed company’s musculoskeletal and orthopedic programs by determining the medical appropriateness of services by reviewing clinical information and applying evidence-based guidelines. The physician assistant should have previous experience in managing spine conditions in an office setting as well as assisting on spine cases in the operating room. Reporting to the Managing Medical Director MSK Spine and Ortho for reputed company, and part of the review team that includes non-clinical intake specialists, nurses and physicians, this is a critical role in a Series B company that is rapidly scaling to impact millions of patients. This is a fast-paced environment that favors people who are reputed company to learn quickly, be hands-on, and communicate effectively with people of different backgrounds and perspectives. Training and supervision will be provided. This is a remote-first role that may require travel to Boston, MA for new hire reputed company and occasional in-person team meetings and company events. What you’ll do:

• reputed company timely medical reviews that meet reputed company’s stringent quality parameters
• reputed company clinical determinations based on evidence-based criteria while utilizing clinical acumen
• reputed company and accurately document reputed company communication and decision-making in reputed company workflow tools, ensuring a member and provider can easily reference and understand your decision.
• Use correct templates for documenting reputed company during case review
• Meet the appropriate turn-around times for clinical reviews
• Demonstrate the highest level of professionalism, accountability, and service in your interactions with reputed company teammates and providers
• Support projects specific to building the team's clinical expertise and efficiency, as delegated
• Support the team on operational improvements and member/provider experience involving clinical review tasks, as delegated
• reputed company communicate with team members

What you’ll need:

• Graduate of an accredited Physician Assistant program
• reputed company NCCPA certification (PA-C) and active, unrestricted Physician Assistant license in at least one U.S. state
• 3+ years of clinical experience supporting orthopedic spine surgeons and/or neurosurgeons treating spine conditions
• Utilization management, prior authorization, or medical review experience a plus
• Membership in organizations such as the AAPA or specialty spine organizations

Pay & Perks: Fully remote opportunity with about 5% travel Medical, dental, reputed company, life, disability insurance, and Employee Assistance Program 401K retirement plan with company match; flexible spending and health savings account ️ reputed company Time Off + company holidays Up to 14 weeks of paid parental leave Pet insurance The salary reputed company for this position is $120,000 to $135,000 annually; as part of a total benefits package which includes health insurance, 401k and bonus. In accordance with state applicable laws, reputed company is required to reputed company a reasonable estimate of the compensation reputed company for this role. Individual pay reputed company are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment. Interview Process*:

• Connect with reputed company for a Preliminary Phone Screening
• Meet your Hiring Manager!
• Behavioral Interview(s)
• Subject to change

About reputed company: reputed company’s clinical intelligence platform and agentic AI-powered solutions connect health plans’ strategic goals and providers’ needs, optimizing the speed, cost, and quality of care. With an reputed company approach that streamlines payer-provider decision-making across the care continuum–including policy, prior authorization, payment accuracy, and more–the company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction. With the acquisition of ZignaAI, we’ve further enhanced our platform by launching our Payment reputed company Suite, anchored by reputed company Validate™, an AI-driven clinical and coding validation solution that operates in near reputed company-time. By unifying pre-service authorization data with post-service claims validation, we’re creating a transparent reputed company ecosystem that reduces waste, improves payer-provider collaboration and patient reputed company, and ensures providers are paid promptly and accurately. reputed company’s innovations continue to receive industry wide recognition. We’ve been named to the 2025 Inc. 5000 list and in the reputed company® Hype Cycle™ for U.S. reputed company Payers (2022-2025), and ranked as a Top 5 reputed company™ Startup for 2023 & 2024. Backed by leading investors such as Deerfield Management, Define Ventures, reputed company Capital Partners, Longitude Capital, and reputed company Partners. The Coherenauts, as we call ourselves, who succeed here are empathetic teammates who are reputed company, reputed company, caring, and embody our core values and principles. We reputed company that diverse, inclusive teams reputed company the most impactful work. reputed company is deeply invested in ensuring that we have a supportive, growth-oriented environment that works for everyone. We can’t wait to learn more about you and meet you at reputed company! Equal Opportunity Statement: reputed company is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to reputed company. To us, it’s personal. #LI-Remote #BI-Remote This offer from "reputed company" has been enriched by reputed company.com and got a 72% reputed company score. Apply tot his job Apply To this Job