PAS Physician Advisor (Level of Care / Admission Status Review)

R1 RCM•Remote, IL, IL

25d•Remote

About The Position

R1 is a leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems, and medical groups. The R1 Physician Advisory Solutions (PAS) team offers a range of services that help navigate the path to compliant revenue. The Admission Status Review (ASR) team of physician advisors within PAS proactively reviews cases concurrently and post-discharge to ensure compliant admission status, which increases compliance and reduces the risk of exposure to denials.

Requirements

Active, unrestricted U.S. MD or DO medical licensure.
At least 3 years of experience post-residency completion, focused on treatment of inpatients.
Strong clinical knowledge base across multiple clinical areas.
Computer proficient.
Strong verbal and written communication skills.
Professional, organized and possess persuasive writing and speaking skills.
Possess strong negotiating/reasoning/logic and problem-solving skills.
Must have flexibility with schedule to meet business need.
Schedules may vary based on business need with the majority of business need late afternoon and evenings on weekdays, and mid-day to evenings on weekends
Weekend work commitment required to include 30% or more of hours on the weekend to include Friday at 7pm through Sunday at midnight EST based on business needs.
Ability to work as part of a team.
Home office that is HIPAA compliant.

Nice To Haves

Current Board Certification
Previous experience with utilization review or chart review

Responsibilities

Addresses compliance and admission status issues.
Review and respond to the customer in a timely manner; usually within 1-2 hours of the submission to the queue.
Must work during pre-scheduled hours to be high successful in this role (schedules are created about 30 days in advance).
Physicians should be highly capable of working independently with a high level of performance in in a rapidly changing, fast paced environment.
Successful physicians will need to meet quality and productivity standards.
Actively engage with attending physicians to discuss appropriate status as supported by documentation.
Make phone contact with utilization review team and/or case managers at client hospitals regarding submitted case determinations.
Provide written analysis of the case and perform case reviews across multiple specialties.