Remote Physician Advisor — Payer Peer-to-Peer Reviews

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

Job summary

R1 RCM Inc. is seeking a Physician Advisor to help client facilities navigate compliant revenue by reviewing payor peer-to-peer cases. You will review denied authorizations, assess documentation for admission status, procedure, and care setting, and advise clients regarding appropriateness of the request with payor medical directors.

This remote position requires strong clinical knowledge across multiple areas and the ability to work independently in a fast-paced environment.

Qualifications

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

Responsibilities

• Review payor peer-to-peer cases to determine authorization status and documentation needs.
• Evaluate whether proper documentation supports admission status, procedure, and care setting requested.
• Advise clients regarding the appropriateness of requests based on available documentation and discussions with payor medical directors.
• Provide written analysis of cases and perform case reviews across multiple specialties.
• Serve as a clinical resource to medical and case management staff by identifying, facilitating, and resolving documentation and utilization issues.

Education

MD/DO medical licensure

Post-residency clinical experience 3+ years

Job description

R1 RCM Inc. is seeking a Physician Advisor to help client facilities navigate compliant revenue by reviewing payor peer-to-peer cases. You will review denied authorizations, assess documentation for admission status, procedure, and care setting, and advise clients regarding appropriateness of the request with payor medical directors.

This remote position requires strong clinical knowledge across multiple areas and the ability to work independently in a fast-paced environment.