Remote Physician Advisor – Payor Authorization Specialist

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

Benefits offered by this job

Benefits package

Job summary

R1 RCM Inc. is seeking a remote Physician Advisor to review payor peer-to-peer cases and determine if authorization is supported by documentation.

You will assess denied authorizations, verify admission status, procedure, and care setting requests, and discuss cases with payor medical directors. Strong clinical knowledge across specialties and independent work style are essential in this fast-paced environment.

Qualifications

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

Responsibilities

• Addresses authorization requested and documentation support or lack of support.
• Review and respond to the payor and customer in a timely manner.
• Engage with payor medical directors to discuss appropriate authorization status.
• Provide written analysis of the case and perform case reviews across multiple specialties.
• Serve as a clinical resource to staff by addressing documentation and utilization issues.

Skills

Active, unrestricted MD/DO licensure

Minimum 3+ years clinical experience

Education

MD or DO medical licensure

Job description

R1 RCM Inc. is seeking a remote Physician Advisor to review payor peer-to-peer cases and determine if authorization is supported by documentation.

You will assess denied authorizations, verify admission status, procedure, and care setting requests, and discuss cases with payor medical directors. Strong clinical knowledge across specialties and independent work style are essential in this fast-paced environment.