MD (Professional Medical Consultant)

Location RANCHO CORDOVA, CA 95670 Status Full Time, Employee Reference Code 2365934 ABOUT EDS:  EDS provides a broad portfolio of business and technology solutions to help its clients worldwide improve their business performance. EDS’ core portfolio comprises information-technology and business process outsourcing services, as well as information-technology transformation services. With more than $21 billion in annual revenue, EDS has been ranked the largest information technology (IT) services firm for the second year in a row by Fortune Magazine in its 2007 Fortune 500 listing. Among the listing's 500 companies, EDS ranked No. 111 overall this year. The company’s stock is traded on the New York (NYSE: EDS) and London stock exchanges.  Learn more at www.eds.com.   WHY EDS: EDS offers employees a broad and unparalleled range of career growth and advancement opportunities based on individual performance and merit. EDS has competitive compensation and an industry leading full benefits package, paid holidays, retirement plan, and more. At EDS we thrive on diversity and team spirit. We are committed to being a great place to work, a trusted business partner and an attractive investment for your career. JOB DESCRIPTION:  PROFESSIONAL MEDICAL CONSULTANT: Under minimal direction, analyzes, reviews and adjudicates questions regarding appropriateness of services and charges. reviews dollar values associated with diagnostic related group (drg) assigned charges to ensure proper payments are made. analyzes claims from doctors and hospitals to ensure medical procedures are appropriate and explainable. evaluates all appealed claims to validate initial action taken. conducts onsite visits of medical facilities to review quality of care. meets with hospital and doctors to discuss questionable claims and charges. JOB ESSENTIAL FUNCTIONS:  PROFESSIONAL MEDICAL CONSULTAN: Ability to analyze, review and adjudicate inquires regarding the appropriateness of services/charges for medical insurance claims. ability to interact with hospital personnel and doctors regarding questionable claims and charges. ability to perform on-site review of medical facilities regarding quality of care. JOB PREREQUISITES:   Holds current doctorate license in the state of California * Demonstrates strong communication skills, both verbal and written * Demonstrates strong customer relations and interpersonal skills * Demonstrates aptitude for and willingness to work as team member * Demonstrates strong analytical skills * Demonstrate strong pc skills * Ability to travel (10% of time)**TO APPLY FOR THIS POSITION** Go to the following link: http://www.edscareers.com  Select and click on link “Search for Jobs” Enter requisition number 2365934 in the “Keywords” field Apply for the position Thank you for your interest!*This position is not one for which the employer will sponsor an individual for employment visa status or pay relocation assistance.EDS IS A REGISTERED MARK AND THE EDS LOGO IS A TRADEMARK OF ELECTRONIC DATA SYSTEMS CORPORATION. EDS IS AN EQUAL OPPORTUNITY EMPLOYER AND VALUES THE DIVERSITY OF ITS PEOPLE. COPYRIGHT 2007 ELECTRONIC DATA SYSTEMS CORPORATION. ALL RIGHTS RESERVED.