Remote Physician Advisor — Payor Case Reviews

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

Benefits offered by this job

Bonus plan

Benefits package

Remote work

Job summary

R1 RCM Inc. is seeking a Physician Advisor to review payor peer-to-peer cases, ensuring proper documentation supports authorization requests for admissions, procedures, and care settings.

The role requires independent work in a fast-paced remote environment with strong clinical knowledge across multiple areas. You will engage with payor medical directors, provide written case analyses, and serve as a clinical resource to medical and case management staff to resolve documentation and utilization

Qualifications

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

Responsibilities

• Review payor peer-to-peer cases to determine if authorization is appropriate.
• Evaluate if the necessary documentation supports the requested admission status, procedure, and care setting.
• Discuss cases with payor medical directors to determine appropriate authorization status.
• Provide written analysis of cases and perform reviews across multiple specialties.
• Serve as a clinical resource to staff, aiding in documentation and utilization issue resolution.

Skills

Clinical experience

MD/DO licensure

Education

MD or DO medical degree

Job description

R1 RCM Inc. is seeking a Physician Advisor to review payor peer-to-peer cases, ensuring proper documentation supports authorization requests for admissions, procedures, and care settings.

The role requires independent work in a fast-paced remote environment with strong clinical knowledge across multiple areas. You will engage with payor medical directors, provide written case analyses, and serve as a clinical resource to medical and case management staff to resolve documentation and utilization