R1 RCM Inc. is a leading provider of technology-enabled revenue cycle management services which transform and solve challenges across health systems, hospitals and physician practices. Headquartered in Chicago, R1® is a publicly-traded organization with employees throughout the US and international locations.Our mission is to be the one trusted partner to manage revenue, so providers and patients can focus on what matters most. Our priority is to always do what is best for our clients, patients and each other. With our proven and scalable operating model, we complement a healthcare organization’s infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience.The Operations Associate I will be responsible for working directly with healthcare insurance companies to recover underpaid hospital claims for our clients. This person will perform resolution analysis which includes reviewing managed care contracts, state or federal legislation, claims billing, and clinical information in order to effectively reconcile underpaid accounts.In this role, Operations Associates work directly with Validation and Client Delivery team members to obtain necessary information for account resolution. Operations Associates are expected to meet monthly project goals and maintain current resolution efforts on all of their assigned projects. This is an excellent opportunity to work in a professional setting with a comprehensive in-house training program. The position also provides performance-based evaluations with opportunity for advancement.This is a hybrid position located in the greater Atlanta, GA area with in-office expectations during the initial onboarding period and as needed thereafter.Responsibilities:
Conduct follow-up calls & payer portal escalations with insurance payers to resolve underpaid hospital claims and maximize reimbursement for hospital clients
Maintain timely, professional follow-up and demonstrate a wide knowledge base on a variety of risk areas and contractual underpayment issues
Understand and articulate claim and contract details to interested parties to facilitate proper billing and reimbursement
Document all communication and actions taken during payer escalations for future reference and tracking purposes
Analyze and interpret denial data to develop evidence-based responses for claim/appeal denials to ensure contractual payment of submitted claims
Perform continual analysis and quality control of underpayment risk areas to ensure audit accuracy
Collaborate with cross-functional teams, key stakeholders, and upper management to optimize reimbursement on accounts
Analyze payer trends and patterns identified during payer interactions identify opportunities for process improvement and implement effective solutions
Required Qualifications:
A Bachelor's degree in Healthcare Administration, Business, or related field or High School diploma with 2+ years' of experience in revenue cycle management, billing, or healthcare finance.
Exceptional critical thinking and analytical skills with the ability to identify patterns, trends, and root causes.
Ability to think on your feet and make informed decisions in a fast-paced environment.
Excellent written and verbal communication skills, with the potential to formulate clear and concise appeals.
Detail-oriented with a high level of accuracy and attention to detail.
Proficient in using Microsoft Office Suite (Word, Excel, PowerPoint) and other relevant software applications.
Experience with revenue cycle management systems and electronic health records (EHR) preferred.
Knowledge of coding systems (e.g., CPT, ICD-10) and medical terminology is a plus.
For this US-based position, the base pay range is $15.00 - $22.64 per hour . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a competitive benefits package. (http://go.r1rcm.com/benefits)R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent (https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf)To learn more, visit: R1RCM.comVisit us on Facebook (https://www.facebook.com/R1RCM)R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation and workflow orchestration.Headquartered near Salt Lake City, Utah, R1 employs over 29,000 people globally and is traded on the Nasdaq stock exchange under the symbol “RCM.”
Full-time