United States onlyR1 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.
As our Operations Associate, you will help recover underpaid hospital claims by working directly with healthcare insurance companies. Every day you will,conduct follow-up calls and portal escalations, articulate claim and contract details, andmaintaintimely resolution actions with insurance payers to effectively reconcile underpaid hospital claims. To thrive in this role you must, use your communication, analysis, and problem-solving skills to meet monthly project goals and maintain current resolution efforts on all assigned projects. The position also provides performance-based evaluations with opportunity for advancement.
Please note the scheduled work hours for this position are 8 AM- 5 PM Pacific Time. Candidates based in Pacific and Mountain time zones are encouraged to apply.
Here’s what you will experience working as an Operations Associate:
Conduct follow-up calls and escalate issues with insurance payers to resolve underpaid hospital claims, maximizing reimbursement.
Maintain professional follow-up, demonstrating knowledge of risk areas and contractional underpayment issues as well as payer policies, guidelines, and regulations to ensure compliance and maximize reimbursement
Document all communications and actions during payer escalations for reference and tracking.
Analyze denial data to develop evidence-based responses for claim and appeal denials, ensuring contractual payment.
Collaborate with cross-functional teams and stakeholders to optimize reimbursement and identify process improvement opportunities.
Required Skills:
High School diploma, GED, or equivalent
Work experience in healthcare billing or completed post-secondary education in medical billing or coding
Ability to communicate effectively verbally and in writing including the ability to ask the right questions and provide detailed documentation
Ability to analyze data, identify patterns and trends and make informed decisions quickly and confidently
Computer proficiency including accurate typing skills; ability to navigate Microsoft Word and Excel
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.
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.
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To learn more, visit: R1RCM.com
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