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Location: Remote, USShift: Weekend Evening schedule F/Sa/Su/M 3-11 PM EST with some flexibilityR1 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 Utilization Review Author, you will help our hospital clients by working alongside our Physician Advisory team to provide first-level initial admission and continued stay case reviews. Every day you will, determine the appropriate cases for review, utilizing client-specific guidelines. Upon identification of a case, you will ensure that appropriate orders and clinical documentation are in place prior to the application of the evidence-based criteria. To thrive in this role, you must have experience in a clinical inpatient environment and hospital-based utilization or case management experience. Proficiency in basic computer skills is essential for excelling in this remote position.Here’s what you will experience working as a Utilization Review Author:<ul> <li>Perform initial admission and continued stay reviews utilizing InterQual or Milliman to identify and support the appropriate level of care.</li> <li>Abstract data from a variety of medical records to ensure accurate clinical data.</li> <li>Adhere to established quality, timeliness, and productivity outputs required in the completion of first-level nursing utilization review.</li> <li>Perform other duties as assigned by departmental leadership in support of departmental and organizational strategies and goals which may include system testing, training, and other opportunities that promote growth.</li> <li>Maintain a compressed weekend schedule of four ten-hour shifts Friday to Monday.</li> </ul>Required Skills:<ul><li>Active Registered Nurse (RN) license in your state of residence, with eligibility to obtain a California RN license</li></ul>For this US-based position, the base pay range is $18.69 - $39.35 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 <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>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 <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>#LI-AC01

R1 RCM

Utilization Review Nurse

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. As our Denials &amp; AR Operations Support I, you will help the denials and AR department to finalize and submit appeals to the payor, so that they can service the client and process incoming correspondence. Every day, you will communicate with the clinical department and work within different portals to submit appeals. To thrive in this role, you must have a production-based background, have experience with insurance verification and hospital registration. Here’s what you will experience working as a Denials &amp; AR Operations Support I:<ul> <li>Be able to identify different types of hospital documentation including, but not limited to, UB-04s, denial/approval letters, EOBs, Hospital account notes, medical records, itemized bills, and Hospital appeal letters.</li> <li>Ensure professional and HIPAA compliant documentation practices.</li> <li>Maintain an understanding of how to utilize provider system platforms and obtain necessary documentation for case files.</li> <li>Utilize clinical guidance on compiling medical records.</li> <li>Identify and communicate appeal deadlines timely through knowledge of insurer timeframes.</li> <li>Update proprietary computer systems to ensure contacts/tasks are closed upon receipt of information requested and received.</li> </ul>Required Skills:<ul><li>High school diploma or GED</li></ul> For this US-based position, the base pay range is $16.29 - $20.36 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 <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>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 <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>

Denials & AR Operations Support I

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. As our Performance Management Manager, you will work across all operational areas within the organization to drive business performance by monitoring key operational metrics, facilitating central operating rhythm, and ensuring coordination between site and Shared Service teams. Every day you will leverage your revenue cycle expertise to help identify opportunities to minimize defects and improve process outcomes, while demonstrating an ability to produce customer-ready deliverables and solid judgement when solving problems. Some of your work products will include financial analyses, process performance reports, process flows, group meeting facilitation, and client relationship development. To thrive in the role, you will be a high-performing hands-on individual who has proven delivery with a strong understanding of revenue cycle and technology. You likely thrive under pressure and see ambiguity and uncertainty as your opportunity to solve problems, innovate and deliver.Here’s what you will experience working as a Manager, Performance Management:<ul> <li>Actively build and participate in the operational rhythm of the business including appropriate communication, insight and inquiries from multiple stakeholders.</li> <li>Partner across teams and with key stakeholders to simplify and scale processes, build and manage SOP’s, and align procedures to changing business models and priorities.</li> <li>Leverage real-world understanding of Physician revenue cycle processes and be an expert and trusted agent of communication to drive both accountability and prioritization of critical operational processes.</li> <li>Additionally, you will use data to generate key insights including variances to best practice, current maturity and performance, adoption levels, and pain points.</li> <li>Ensure that monitoring and controls are relevant and drive accountability across the organization.</li> <li>Deliver analysis on Key Performance Indicators (KPIs) that ensure transparency to performance metrics and tracking toward delivery of company financial commitments.</li> <li>Provide ad hoc analysis to leadership to help articulate performance trends.</li> <li>Evaluate quality and timeliness of deliverables.</li> <li>Develop process solutions through automation, standardization, and innovation.</li> <li>Collaborate with onshore and global leaders to optimize efficiencies around revenue cycle operations adhering to compliance requirements while reducing time away from primary tasks for shared service and site teams to drive process and performance improvement.</li> <li>Participate in cross-functional collaboration discussions to drive KPI improvement.</li> </ul>Required Qualifications:<ul> <li>Obtained Bachelor’s degree in Accounting, Finance, Business Administration, Healthcare Administration, or other science related field.</li> <li>Prior experience of at least 4 years in Physician Revenue Cycle in shared service and/or operations, including working with global teams.</li> <li>Proven ability to look at the world through the eyes of others and interpret business needs in a way that drives the success of others.</li> <li>Attention to detail, highly organized and strong process-focused aptitude.</li> <li>Possess strong leadership and organizational skills and can positively influence others.</li> <li>Ability to think creatively, be analytically minded, objective and independent.</li> <li>Demonstrated ability to negotiate and provide alternative business solutions.</li> <li>Proficiency in Excel and PowerPoint.</li> <li>SQL or Tableau experience.</li> <li>Outstanding time management skills and the ability to simultaneously manage multiple tasks while remaining self-directed.</li> </ul>For this US-based position, the base pay range is $69,556.00 - $114,234.05 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.This job is eligible to participate in our annual bonus plan at a target of 10.00%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 <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>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 <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>

Manager, Performance Manager

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. R1 is seeking a dynamic and experienced Senior Manager of Analytics to drive strategic initiatives and performance management. This position entails leading the performance management and analytics team, serving as the primary liaison between the Operational team and key departments such as Business Intelligence, Commercial, FP&amp;A, and Accounting. The Senior Manager will utilize cross-functional skills and knowledge to operate within and educate on all four pillars of analytics: descriptive, diagnostic, predictive, and prescriptive.Here’s what you will experience working as a Sr. Manager, Analytics – Performance Management:<ul> <li> Strategic Partnership: Engage in close collaboration with leadership and internal stakeholders to develop and execute strategic initiatives. By mastering key performance indicators (KPIs), you will drive efforts to optimize organizational performance and efficiency, ultimately contributing to the success and growth of the organization. </li> <li> Performance Management: Conduct thorough analyses of organizational performance to identify areas for improvement. Develop and implement strategies that boost productivity and efficiency. Establish clear performance goals and hold operational leaders accountable for achieving these targets, ensuring continuous improvement in team outcomes. </li> <li> Leadership: Cultivate a collaborative and supportive team environment that prioritizes delivering actionable insights and fostering continuous improvement. Lead by example and mentor team members, encouraging professional growth and development. Inspire and guide the team to achieve their full potential. </li> <li> Reporting &amp; Analytics: Innovate and develop comprehensive reporting and analytics content to enhance transparency and provide deeper insights into key initiatives and activities. Leverage data to inform strategic decisions and drive business success. Evaluate and recommend business intelligence (BI) tools and solutions that meet the unique needs of the organization. </li> <li> Communication: Effectively communicate complex concepts to both technical and non-technical audiences. Translate functional requests into technical requirements for developers, ensuring alignment and understanding across all stakeholders. Tailor communication strategies based on stakeholder preferences and needs to ensure clarity and engagement. </li> </ul> Required Skills:<ul> <li>Ideally 6+ years of experience in an analytics-related role within a fast-paced, high-growth environment.</li> <li>Strong leadership and team management skills, with a demonstrated ability to lead and inspire a team of analysts.</li> <li>Demonstrated finance (P&amp;L) knowledge. </li> <li>Advanced Excel data modeling skills.</li> <li>Proficiency in SQL, data visualization tools (e.g., Tableau, Power BI), &amp; analytics platforms.</li> <li>Experience with Salesforce or similar CRM systems.</li> <li>RCM or Healthcare experience is a plus.</li> </ul>For this US-based position, the base pay range is $116,133.00 - $173,605.10 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.This job is eligible to participate in our annual bonus plan at a target of 10.00%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 <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>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 <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>

Sr. Manager, Analytics - Performance Management

Location: Remote, US Hours: Shift-based schedule spanning 6am-2am CT, 7 days a week, including holidays and weekends 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. As our EMR Specialist, you will be responsible for assisting physicians by pulling patient records from EMR systems. Every day you will review customer records and upload them into a portal. To thrive in this role, prior experience with electronic health information systems, procedures and control techniques associated with confidentiality, integrity and functional knowledge of network defenses, and HIPPA laws and policies is preferred. Attention to detail and proficiency in basic computer skills is essential for excelling in this remote, production-driven position.Here’s what you will experience working as an EMR Specialist:<ul> <li>Maintain working EMR access for navigation and basic troubleshooting.</li> <li>Perform accurate and thorough data entry while maintaining productivity standards.</li> <li>Maintain communication with physician teams regarding cases, case completion, and portal workflow.</li> <li>Attach pertinent clinical information to portal cases and follow cases to completion within service level agreements.</li> </ul>For this US-based position, the base pay range is $16.88 - $25.51 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 <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>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 <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>#LI-AC01

EMR Specialist

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. The OBGYN Coding Associate II will be responsible for reviewing clinical documentation and diagnostic results as appropriate (i.e., to extract data and apply appropriate ICD-10-CM, HCPCS and CPT-4 codes for billing, review and correct billing edits, internal and external reporting, research, and regulatory compliance). Under the direction of the Coding Leadership Team, the successful candidate must be able to accurately code conditions and procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting.Here's what you can expect as our OBGYN Coding Associate II:<ul> <li>Assigns codes for diagnoses, treatments and procedures according to the appropriate classification system for professional service encounters to determine the highest level of specificity ICD-10 codes, CPT codes, HCPCS codes, and modifiers.</li> <li>Reviews physician assigned diagnosis code after thorough review of the medical record and, if necessary, queries physician for additional clarity in a professional manner.</li> <li>Able to accurately abstract information from the medial records into the abstract system, according to established guidelines.</li> <li>Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and American Academy of Professional Coders (AAPC) adheres to official coding guidelines</li> <li>Enters and validates codes, charges and other edits flagged in Athena or EPIC for review.</li> <li>Review documentation (and returned accounts) to verify and correct place of service, billing and service providers, or other missing data elements (ie: NDC #, or number of units)</li> <li>Uses CCI edit software to check bundling issues, modifier appropriateness, and LCD’s/NCD’s for medical necessity.</li> <li>Communication with other departments to recommend coding guidance for charge corrections, appeals processes, and patient billing concerns.</li> <li>Meet and/or exceeds the established coding productivity standards</li> <li>Meet and/or exceeds the established quality standard of 95% accuracy while meeting and/or exceeding productivity standards</li> </ul> Required Qualifications:<ul> <li>High School Diploma or GED required CCS-P, CPC</li> <li>Two (2) years of OB-GYN experience</li> <li>Must be able to demonstrate proficiency in professional services (95% accuracy).</li> <li>Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA) (ie: Documentation Guidelines ’95 &amp; ’97)</li> <li>Extensive knowledge of government, and commercial payer guidelines.</li> <li>Must be able to use standard office equipment and information systems.</li> <li>Ability to interact with other employees through effective communication.</li> <li>Ability to prioritize and shift workloads to ensure departmental goals align with revenue cycle goals </li> </ul>For this US-based position, the base pay range is $17.58 - $27.14 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 <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>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 <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>

OBGYN Coding Associate II

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. The Financial Counselor will be responsible for counseling patients or parties responsible for payment. The Patient Financial Counselor will educate patients on their responsibilities and potential options. The PFC is responsible for accurately and compassionately explaining to the patient their financial obligations during the financial counseling session. In addition, the counselor must obtain any necessary pre-certifications or authorizations and assist with any financing or third-party applications. In this role, the successful candidate must display a strong sense of patient care and attention to detail. Here’s what you will experience working as a Financial Counselor: <ul> <li>Explain financial responsibilities for services received payment options and collection procedures to patients or parties responsible for payment. </li> <li>Counsel patients regarding insurance benefits and recommend alternative sources of payment and financial assistance when appropriate. </li> <li>Contact insurance carriers or other sources and act as an advocate for the patient. </li> <li>Initiate process for collecting prepays due and perform follow up activity to insure maximum collection is achieved. </li> <li>Identify hospital, public and private financial assistance programs for patients unable to meet their financial obligations. </li> <li>Work with Case Management, Clinical Staff, Medicaid Vendor, and Family Independence Agency to assist patients and families in completing assistance program applications and determine eligibility and coverage. </li> <li>Notify manager, physician and servicing department of possible delay of service for any elective, urgent admissions, procedures and scheduled diagnostic testing which have not been approved prior to the date of service. </li> <li>Maintain accurate documentation of pre-processing information. </li> <li>Provide assistance to uninsured patients and families in completing and filing Medicaid or assistance program applications with the appropriate agency. </li> <li>Perform all other duties and projects as assigned. </li> </ul>Required Skills: <ul> <li>High school diploma is required </li> <li>At least one year of call center experience </li> <li>Attention to detail </li> <li>Strong customer service experience </li> <li>Ability to multi-task and navigate between multiple systems simultaneously </li> <li>Ability to handle a large volume of incoming calls </li> </ul>For this US-based position, the base pay range is $14.42 - $20.24 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 <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>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 <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>#tj2022 #healthcare #customerservice #financialcounseling #banking #LI-TJ2022

Financial Counseling Representative I

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. As our R37 GenAI Lab Senior Process Analyst in the Perfect Claim pillar, you will play a key role in both the assessment and optimization of existing edits and the design and implementation of future edits within a novel claim scrubber system. This position requires an analytical mindset, strong collaboration skills, and the ability to drive innovation in claim processing. To thrive in this position, you will need to be an innovative self-starter and a collaborator as you work with both external vendors and internal partners to achieve goals. You’ll use your prior experience in conceptualizing and developing products and framework to help shape the future state of work, as we build a new GenAI enabled product platform. Here's what you will experience working as a Senior Process Analyst: <ul> <li>Analyze and optimize current edits in claim scrubbers to improve claim processing accuracy and efficiency. </li> <li>Design new edits to address future needs, anticipating changes in claim processing requirements based on payer policies and reimbursement guidelines.</li> <li>Collaborate with cross-functional teams to implement optimization solutions and new edits. </li> <li>Monitor and evaluate the performance of edits, making data-driven recommendations for further enhancement. </li> <li>Ensure compliance of edits with industry standards and regulations. </li> <li>Conduct testing and validation to ensure new edits function accurately and effectively. </li> <li>Analyze trends and patterns to predict future requirements and challenges in claim processing. </li> <li>Produce detailed reports and presentations to communicate findings, analytics, and recommendations. </li> <li>Travel domestically and internationally; 25-50%.</li> </ul> Required Qualifications: <ul> <li>Bachelor's Degree</li> <li>5-8 years of experience in healthcare operations (i.e. revenue cycle management, provider, payer, vendor).</li> <li>Expertise in healthcare billing operations.</li> <li>Strong project management skills with demonstrated track records in quality and operational improvements, ability to prioritize workload, meet deadlines, and perform multiple tasks simultaneously.</li> </ul> For this US-based position, the base pay range is $109,118.00 - $187,269.24 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.This job is eligible to participate in our annual bonus plan at a target of 20.00%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 <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>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 <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>

US-Process Analyst

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. As our Senior Manager of Client Success, you will serve as a trusted advisor and reliable advocate for clients, overseeing the client experience throughout the full revenue cycle, ensuring optimal financial outcomes, client satisfaction, and long-term retention. As an industry expert, this role serves as the primary liaison between the organization and its clients, driving strategic initiatives to enhance revenue performance, streamline operations, and ensure compliance with industry regulations.Every day you will collaborate cross-functionally with internal teams—such as billing, coding, operations, and technology—to align solutions with client goals. The Senior Manager will offer strategic guidance, support clients in maximizing revenue collection, reducing costs, and improving the overall financial health and performance of the account. To thrive in the role, you will be a a strategic thinker with strong leadership skills, a client-focused mindset, and deep knowledge of revenue cycle management industry and processes, including patient access, billing, coding, collections, and compliance.Here’s what you will experience working as a Senior Manager of Client Success:Client Relationship Management <ul> <li>Develop and maintain strong relationships with key stakeholders across client organizations to deliver an exceptional client experience.</li> <li>Serve as the primary point of contact, ensuring client satisfaction and retention.</li> <li>Address client concerns promptly and work proactively to prevent potential issues.</li> <li>Coordinate and communicates client contractual details for SLAs, performance-based pricing, fees and terms with analytics and finance teams. Communicates periodic changes based on contract amendments.</li> <li>Responsible for identifying customer needs, develop and seek buy-in on solutions and manage through the change process at the account level.</li> </ul>Client Onboarding and Implementation Success<ul> <li>Assist in facilitating the new client onboarding process to ensure smooth transition from the sales and contracting phase to the operational phase of the engagement.</li> <li>Ensure alignment of expectations.</li> <li>Develop tailored strategies to support each client's unique revenue cycle challenges and goals.</li> <li>Provide training and education to clients on RCM processes and technology.</li> </ul>Required Skills:<ul> <li>Bachelor's degree in healthcare administration, business, or related field (Master’s preferred).</li> <li>7+ years of experience in revenue cycle management, healthcare operations, or client success roles.</li> <li>Physician billing experience in specialty groups; radiology, surgical, primary care, and/or others.</li> <li>Strong knowledge of RCM processes, including billing, coding, claims management, and reimbursement.</li> <li>Excellent communication, interpersonal, problem-solving, and leadership skills.</li> <li>Proficiency in utilizing and optimizing EMR systems such as eClinicalWorks, NextGen, Epic, or Meditech</li> <li>Excellent written and oral communication skills (including presentation experience) required.</li> <li>Advanced computer skills including knowledge of patient accounting systems, analytic tools, and Microsoft Office Suite.</li> <li>Strong track record in managing multiple clients and priorities effectively.</li> <li>Demonstrated success in performance monitoring, revenue optimization, and process improvement.</li> <li>Strong analytical skills with experience in financial reporting, KPI tracking, and revenue performance analytics.</li> <li>Familiarity with healthcare compliance regulations such as HIPAA, CMS guidelines, and payer requirements.</li> </ul>Pay Range - $100,000 - $130,000 annually.For this US-based position, the base pay range is $80,019.00 - $127,950.31 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.This job is eligible to participate in our annual bonus plan at a target of 10.00%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 <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>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 <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>

Senior Manager, Client Success

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. The Coding Liaison works with the Coding Liaison Manager and Director of Coding Quality Management to establish open lines of communication regarding potential coding quality concerns. The Coding Liaison assists with coding review inquiries related to ICD-10, CPT, DRG/APR-DRG or APC codes. Our collaborative partners include the following R1 teams: Coding, Quality, Education and Training Teams, Revenue Integrity, CDM and PFS/Site Leaders. The coding liaison team also works with site customers including CDI, Quality/Risk, Case Management, Patient Advocate’s, Physician Advisors, Clinical Departments and Administration. Here's what you'll experience working as a Coding Liaison:<ul> <li>Completes requests from customers and collaborative partners noted above to determine if coding quality issues exist. Review results are shared with Local and Regional Coding Site managers, Coding Advisory team and R1 Education and Training team as needed when coding issues are identified</li> <li>Works with the CDI team, assisting with the resolution of documentation inconsistencies and DRG variances</li> <li>Educates the CDI team and Physician Advisor on coding changes, DRGs, Official coding guidelines and documentation requirements</li> <li>Attends various meetings to include CDI/Mortality/PSI/Revenue Integrity/R1 Coding Quality as needed</li> <li>Works with the Quality &amp; Risk teams to review coding related to HACs, PSI, Mortalities, Core Measures and focused CMS initiatives</li> <li>Provides coding education/guidelines to Quality and Risk, related to HAC, PSI, Mortalities, Core Measures and all other CMS reporting related to pay for performance</li> <li>Conduct coding reviews related to potential lost revenue via Axiom and high dollar medical necessity edits</li> <li>Identify trended coding quality issues requiring new or refresher coder education for accurate and compliant code, DRG/APR-DRG, APC assignment</li> </ul> Required Qualifications:<ul> <li>RHIA, RHIT, CCS certifications or a combination is required</li> <li>Minimum of five (5) years of inpatient coding</li> <li>Minimum of three (3) years of coding auditing</li> <li>Strong problem-solving skills</li> <li>Strong analytical skills and ability to comprehend and analyze large quantities of operational data</li> <li>Ability to review complex medical records</li> <li>Ability to interact professionally with other associates, department directors and the Medical Staff through effective verbal and written communication</li> <li>Experience with Excel, PowerPoint and Word</li> <li>Strong communication and presentation skills</li> </ul> Preferred Qualifications:<ul> <li>Experience in a large (&gt; 500 beds) hospital or multi-hospital health system</li> <li>Experience working with the CDI team is preferred</li> <li>Prefer additional knowledge/experience in outpatient coding</li> <li>Training in hospital Clinical Documentation Improvement</li> <li>Inpatient or outpatient coding audit experience</li> </ul>For this US-based position, the base pay range is $18.69 - $39.35 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 <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>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 <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>

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