Remote Physician Advisor: Denials & Utilization Review

R1 RCM, Inc.; Mississippi; Hybrid; USD 150,000 - 199,000; Full time

Benefits offered by this job

Annual bonus plan

Job summary

R1 RCM Inc. is seeking a Physician Advisor to support client facilities in navigating compliant revenue by reviewing payor peer-to-peer cases.

You will evaluate denials for admission status, procedure, and care setting and advise on the appropriateness of requests based on documentation. The role requires strong clinical knowledge across specialties, independence in a fast-paced remote environment, and proficiency with basic computer skills.

Qualifications

• Active, unrestricted MD or DO medical licensure.
• Minimum 3+ years of clinical experience post-residency.

Responsibilities

• Review payor peer-to-peer cases for authorization decisions.
• Advise clients on the appropriateness of requests based on documentation.
• Discuss cases with payor medical directors to determine authorization status.
• Provide written analysis of cases and perform reviews across multiple specialties.
• Serve as a clinical resource to medical and case management staff to resolve documentation and utilization issues.

Skills

MD/DO License

3+ Years Clinical Experience

Education

MD/DO degree

Job description

R1 RCM Inc. is seeking a Physician Advisor to support client facilities in navigating compliant revenue by reviewing payor peer-to-peer cases.

You will evaluate denials for admission status, procedure, and care setting and advise on the appropriateness of requests based on documentation. The role requires strong clinical knowledge across specialties, independence in a fast-paced remote environment, and proficiency with basic computer skills.