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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 Hospital Coding Auditor, you will review hospital charges against medical record and all applicable documentation to determine appropriate code assignments on services provided (CPT/HCPCS codes). The Auditor must have a comprehensive understanding of medical terminology, coding, contractual agreements, and various payment methodologies. This position requires good time management skills and the ability to work independently. Here’s what you will experience working as a Hospital Coding Auditor <ul> <li>Review hospital charges against medical record and all applicable documentation to determine appropriate code assignments on services provided (CPT/HCPCS codes) </li> <li>Understand billing and coding requirements for government and commercial payers. </li> <li>Abstract statistical data from the patient record and enter information following facility guidelines. </li> </ul><ul> <li>Follow all HIPAA regulations and uphold a higher standard around privacy requirements. </li> <li>Maintain at least a 95% accuracy rate. </li> <li>Maintain productivity standards, tracking logs and deadlines. </li> </ul>To be successful in this role, you must have:<ul><li>CPC, CCS, CPC-H (COC), CPMA, CIC, RHIA, RHIT and/or CCS-P certification </li></ul><ul> <li>Experience in billing, charge documentation, charge audit or charge capture activities, or other functions related to revenue cycle activities. </li> <li>Experience coding multi-specialties preferred that may include trauma, orthopedics, cardiology, interventional radiology, and neurology. </li> <li>Must possess a demonstrated knowledge of clinical processes; clinical coding (CPT, HCPCS, ICD-10, revenue codes, status indicators, and modifiers), charging processes and audits. </li> </ul><ul> <li>Knowledge of CMS guidelines, Ambulatory Payment Classification, and Outpatient Prospective Payment System, reimbursement structures and prebill edits including Outpatient Coding Edits/Correct Coding Initiative edits preferred. </li> <li>Experience with encoder technology and electronic medical record systems. </li> <li>Ability to work in a flexible environment, adapting to changing priorities.</li> <li>Excellent organizational skills and strong attention to detail</li> </ul>For this US-based position, the base pay range is $43,888.00 - $70,631.44 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 5.00%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>

Hospital Coding Auditor

Job Description 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 Client Experience Director (CXD) will serve as one of the primary points of contact for all day-to-day activities within the Client Experience Team. The CXD will be responsible for establishing trusted relationships with their assigned clients, and when appropriate expand our partnerships through selling new solutions. This person will be responsible for providing support to the Client Experience Team to which they are assigned as well as collaborating across various departments within R1 to drive high client satisfaction and safeguard client retention. To thrive in this role, you must have a dynamic personality who approaches external relationships from the client’s perspective using effective and proactive communication, analytical skills, and daily leadership. The CXD will be tasked with various project leadership opportunities that require a high-level of cross-collaboration with multiple organization units. RESPONSIBILITIES <ul> <li>Client Relationship/Management: 30%</li> <li>Collaboration with other R1 functions: 30%</li> <li>Client Business Reviews and Meetings: 20%</li> <li>Introducing and selling new solutions to existing clients, including having a target sales quota: 15%</li> <li>Document the client experience in CRM: 5%</li> <li>Drive high Net Promoter Score (NPS) results across their client portfolio.</li> <li>Work collaboratively across functions to ensure operational excellence to nurture and ensure client satisfaction leads to growth and retention.</li> <li>Ensure mutual understanding of goals, objectives and action plans related to client’s revenue and book of business.</li> <li>Participate in the contracting and contract renewal process.</li> <li>Contribute to region and client-level strategic planning.</li> <li>Lead the creation and presentation of business reviews.</li> <li>Assist in the implementation of new solutions and onboarding of new clients.</li> <li>Follow best-practice account management and client experience methodologies.</li> </ul> REQUIRED QUALIFICATIONS <ul> <li>4+ years of account management, client experience management, and/or revenue cycle operations consulting experience working with Director-level partners is preferred.</li> <li>Healthcare revenue cycle and revenue integrity experience working with acute care provider organizations.</li> <li>Outstanding organization and prioritization skills</li> <li>Exceptional written and verbal communication skills</li> <li>Bachelor’s degree</li> <li>Proficiency with Microsoft Office, including basic to intermediate Excel functions, and CRM application use (preferred: Salesforce)</li> <li>Ability to travel up to 40%</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.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>

Director of 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. As our Clinical Coding Appeals Nurse, you will help review and interpret medical records to draft appeals of denied and underpaid claims. Every day you will review medical records to ensure appropriate coding of removed or revised diagnosis and procedure codes. Then you will draft appeal letters based on clinical judgment and knowledge and make coding change suggestions to our clients based on ICD-9/10 CM &amp; PCS, CPT, HCPCS, and NCCI guidance. To thrive in this role, you must have experience identifying different types of hospital documentation including, but not limited to, medical records, UB-04s, EOBs, itemized bills, hospital account notes, appeal letters, and denial/approval letters. Proficiency in basic computer skills is essential for excelling in this remote production-drive position.Here’s what you will experience working as a Clinical Coding Appeals Nurse:<ul> <li>Review and interpret medical records to appeal denied and underpaid claims.</li> <li>Apply clinical judgment and knowledge for DRG downgrades performed because of a Clinical Validation Review by an insurer or third-party auditor.</li> <li>Draft appeal letters that are well-written, logically structured, and persuasive, utilizing ICD-9/10 CM &amp; PCS, CPT, HCPCS, NCCI guidance.</li> <li>Ensure that all appeals are completed timely to ensure internal and external compliance deadlines are met.</li> </ul>Required Skills:<ul> <li>Active Registered Nurse license</li> <li>An active CCS, RHIA, RHIT, CCA, CPC-A, CPC-H, COC, CPMA, CIC, CDI, or CDIP certification OR 2+ years of CDI experience</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>#LI-AC01

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