Payer Peer to Peer Physician Advisor

🕒 July 11

🇺🇸 United States – Remote

💵 $150.1k - $199.1k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

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Logo of R1 RCM

R1 RCM

10,000+ employees

Founded 2017

💼 Consulting

📦 Logistics

🏥 Healthcare

💰 Private Equity Round on 2024-07

Consulting • Logistics • Healthcare

R1 RCM is a leading provider of revenue cycle management solutions for the healthcare industry. With an emphasis on maximizing financial performance and optimizing patient care, R1 offers a comprehensive platform that integrates data analytics, intelligent technologies, and deep expertise in revenue cycle management. The company assists healthcare providers—ranging from hospitals and health systems to physician and specialty care practices—in capturing revenue opportunities, improving payer and patient cash flows, and ensuring compliance with government regulations. R1 is committed to driving cost reductions and revenue improvements while enhancing the patient experience. Their suite of services includes revenue recovery, clinical integrity, and regulatory navigation, making them a trusted partner for many top healthcare providers.

📋 Description

• Review payor peer-to-peer cases for authorization status • Evaluate documentation for admission status, procedure, and care setting • Advise clients on appropriateness of requests based on documentation • Engage with payor medical directors regarding authorization status • Provide written analysis of cases and perform reviews across specialties • Serve as a clinical resource for medical and case management staff

🎯 Requirements

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

🏖️ Benefits

• Job is eligible to participate in our annual bonus plan at a target of 10.00% • Competitive benefits package

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