Remote Physician Advisor: Payor Case Reviews

R1 RCM, Inc.; Clayton (NC); 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 by reviewing payor peer-to-peer cases daily. You will assess denied authorizations, ensure documentation supports admission status, procedures, and care settings requested.

You will advise clients on appropriateness based on available documentation and discuss cases with payor medical directors. The role requires strong clinical knowledge across multiple areas and the ability to work independently in

Qualifications

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

Responsibilities

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

Skills

MD/DO license

Clinical experience

Education

MD/DO degree

Job description

R1 RCM, Inc. is seeking a Physician Advisor to help client facilities navigate compliant revenue by reviewing payor peer-to-peer cases daily. You will assess denied authorizations, ensure documentation supports admission status, procedures, and care settings requested.

You will advise clients on appropriateness based on available documentation and discuss cases with payor medical directors. The role requires strong clinical knowledge across multiple areas and the ability to work independently in