Remote Physician Advisor: Payor Case Review & Utilization

R1 RCM; United States; Remote; USD 150,000 - 199,000; Full time

Job summary

R1 RCM Inc. is seeking a Physician Advisor to help client facilities navigate compliant revenue through payor peer-to-peer case reviews and documentation evaluation.

You will assess authorization requests, verify admission status, procedure and care setting documentation, and discuss cases with payor medical directors. Requirements include active, unrestricted MD or DO licensure and 3+ years of clinical experience post-residency; this is a remote US-based role with a $150k–$199k base, plus a 10%

Qualifications

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

Responsibilities

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

Skills

MD or DO licensure

3+ years clinical experience

Education

MD or DO degree

Job description

R1 RCM Inc. is seeking a Physician Advisor to help client facilities navigate compliant revenue through payor peer-to-peer case reviews and documentation evaluation.

You will assess authorization requests, verify admission status, procedure and care setting documentation, and discuss cases with payor medical directors. Requirements include active, unrestricted MD or DO licensure and 3+ years of clinical experience post-residency; this is a remote US-based role with a $150k–$199k base, plus a 10%