field_remote_option

field_job_occupational_field_parents_all

job_organization_name

job_upgrade_is_featured

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>

R1 RCM

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. 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

Clinical Coding Appeals Nurse

At R1 RCM we are a leading provider of technology-driven solutions that transform the patient experience and financial performance of healthcare providers. We deliver proven ROI across the entire revenue cycle – front, middle and back office. This enables our customers to achieve an optimal revenue cycle – one that promotes patient satisfaction and improves financial performance.As our DRGV Auditor II, your primary role will be auditing inpatient cases for DRG validation and/or documentation improvement. This consists of reviewing accounts in proprietary software and client EMR systems to validate the accounts. Opportunity for growth includes a client facing Lead Auditor role and an internally facing Mentor role. Every day in this role you will:<ul> <li>Review inpatient medical records for validation of DRG assignment </li> <li>Provide detailed rationale and supporting evidence for recommendation and findings </li> <li>Utilize industry-recognized references to support their review findings, such as the ICD-10 Official Guidelines for Coding and Reporting, AHIMA Standards of Ethical Coding, AHIMA Practice Briefs related to compliant querying, and AHA Coding Clinics </li> </ul>To succeed in this role, you must have:<ul> <li>Current AHIMA credentials of one or more of the following are required: RHIA, RHIT, and/or CCS </li> <li>3+ years of ICD-10 auditing and DRG reimbursement experience, with recent acute inpatient auditing experience </li> </ul>For this US-based position, the base pay range is $51,700.00 - $95,429.25 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>

DRGV Auditor II

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. As the Government Navigation Services (GNS) Business Development Director, you will focus on engaging and targeting new Tier 1 and Tier 2 target accounts (i.e., high-value prospects). On a day-to-day basis, in addition to prospecting and networking initiatives, the GNS Business Development Director will partner with the Business Development teams of in-house and outsourced lead generation professionals to build an active sales funnel (i.e., sales staged Qualified and above) with booking values equal to or greater than sales quota in estimated first-year revenue.To thrive in this role, you will utilize your expertise in Medicare reimbursement, specifically Medicare Bad Debt, Disproportionate Share (DSH), and Worksheet S-10 (Uncompensated Care) to navigate development discussions with prospective clients. Responsibilities:<ul> <li>Develop and execute a strategy that aligns with company objectives to rapidly build brand awareness and drive new revenue</li> <li>Navigate Government Reimbursement</li> <li>Meet or exceed annual goals as assigned</li> <li>Accurately forecast attainment on a monthly, quarterly, and annual basis</li> <li>Ensure sales activity is documented correctly through the CRM automation tool (Salesforce)</li> <li>Collaborate in a team selling environment to identify, pursue and capture new client relationships. </li> <li>Build trusting relationships with potential clients</li> </ul> Requirements:<ul> <li>10+ years of experience selling services surrounding Medicare reimbursement, combined with a strong/effective presence with hospital and health systems' various leadership teams and executives, including the C-suite, with a proven ability to develop relationships and gain buy-in</li> <li>Experience navigating Medicare reimbursement</li> <li>Expertise in Medicare Bad Debt, DSH, Worksheet S-10</li> <li>Ability to travel up to 50%</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.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>

Business Development Director-Government Reimbursement

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>

Senior 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>

Coding Liaison

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 Inpatient Coding Quality Reviewer will be responsible for reviewing inpatient coded cases for coding completeness and accuracy. This person will identify potential coding and DRG errors, researches appropriate guidelines to support recommended changes, and communicates the changes to the coder involved on a timely basis. The Reviewer provides expert coding advice to coding staff and relays needed coding educational topics to the Regional Manager, IP Coding Quality. This role will report to the Regional Manager of Inpatient Coding Quality. Here’s what you will experience working as a (Inpatient Coding Quality Reviewer): <ul> <li>Review inpatient coded cases for coding completeness and accuracy. </li> <li>Identify potential coding and DRG errors, research appropriate guidelines to support recommended changes, and communicate changes to the coder involved on a timely basis. </li> <li>Provide expert coding advice to coding staff and relay needed coding educational topics to the Regional Manager, IP Coding Quality. </li> <li>Conduct daily pre-bill review of cases flagged by the PwC SMART coding quality monitoring software tool. </li> <li>Maintain required productivity standards and high-quality results. </li> <li>Audit records as defined in the coding quality review plan. </li> <li>Review cases flagged by the coding quality software on a daily basis for multiple hospitals. </li> <li>Validate the completeness of documentation, identify missed diagnoses and procedures, propose physician queries, and ensure the accuracy of diagnoses, procedures, POA, discharge disposition, and DRG assignment. </li> <li>Perform retrospective coding quality reviews as requested. </li> <li>Maintain up-to-date knowledge of industry coding and documentation guidelines to ensure system-wide coding consistency and compliance. </li> <li>Communicate audit findings with coders in a timely manner and support teams in addressing and resolving local coding issues. </li> <li>Serve as an inpatient coding expert and resource for the coding teams and other departments. </li> <li>Work with the Regional Manager to identify areas of educational need based on audit results. </li> <li>Assist with evaluation and testing of audit applications and updates as needed. </li> <li>Work with the hospital’s CDI team to address and resolve documentation issues. </li> <li>Assist with compilation, generation, and analysis of data for results reporting and performance improvement initiatives. </li> <li>Contribute to the reduction of the hospital's and Company’s coding compliance risks and revenue enhancement goals. </li> <li>Maintain an open dialogue and a good working relationship with team members. </li> <li>Assist with training of new auditors and other audits and duties as requested. </li> </ul> Required Skills: <ul> <li>Bachelor's or Associate's Degree with CCS credential. </li> <li>A minimum of seven (7) years of hospital inpatient coding experience. </li> <li>Extensive knowledge of ICD-10-CM/PCS classification system and MS-DRG and APR-DRG methodologies. </li> <li>In-depth knowledge of medical terminology, human anatomy/physiology, pharmacology, and pathology. </li> <li>Expert knowledge of industry Official Coding and Reporting Guidelines, CMS, and other agency directives for ICD-10 coding. </li> <li>Proficient MS Office computer skills, specifically in Excel, and knowledge of various coding software/platforms and EMRs. </li> <li>Detail-oriented with the ability to work independently and maintain a high productivity rate and coding accuracy rate. </li> <li>Effective communication skills and a self-starter attitude. </li> </ul> Desired Qualifications: <ul> <li>Two (2) years of inpatient coding audit experience. </li> <li>Experience in a large (&gt; 500 beds) hospital or multi-hospital health system. </li> <li>Training in hospital Clinical Documentation Improvement. </li> <li>Experience as a Coding Consultant with a consulting firm. </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>#remote #healthcare #tj2022

62 R1 RCM Jobs