Remote Physician Advisor: Payer Peer-to-Peer Reviews

R1 RCM, Inc.; Utah; Remote; USD 150,000 - 199,000; Full time

Benefits offered by this job

Competitive benefits

Annual bonus plan

Job summary

R1 RCM, Inc. is seeking a Physician Advisor to review payor requests and determine documentation adequacy for admission status, procedure, and care setting.

You will discuss cases with medical directors from payor side and advise clients on appropriateness of requests, working from home in a fast-paced, remote environment. The ideal candidate holds an active MD or DO license, has 3+ years of clinical experience, and can meet quality and productivity standards.

Qualifications

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

Responsibilities

• Review payor peer-to-peer cases where authorization has been denied.
• Evaluate whether proper documentation supports admission status, procedure, and care setting.
• Advise clients on the appropriateness of requests based on available documentation.
• Discuss cases with medical directors from the payor side.
• Engage with attending physicians to discuss status as supported by documentation.
• Make phone contact with utilization review team and/or case managers regarding determinations.
• Provide written analysis and perform case reviews across multiple specialties.

Skills

MD/DO license

Clinical experience

Education

MD/DO medical degree

Job description

R1 RCM, Inc. is seeking a Physician Advisor to review payor requests and determine documentation adequacy for admission status, procedure, and care setting.

You will discuss cases with medical directors from payor side and advise clients on appropriateness of requests, working from home in a fast-paced, remote environment. The ideal candidate holds an active MD or DO license, has 3+ years of clinical experience, and can meet quality and productivity standards.