Develop and enforce database design standards and governance policies to ensure data integrity and quality. Architect high-availability strategies and performance optimization initiatives across hybrid cloud environments.
R1 RCM
32 Remote Job Openings at R1 RCM
Review denied authorization cases to evaluate if documentation supports the requested admission status and care setting. Provide clinical consultations and root cause analysis to client hospitals to improve billing accuracy and reduce accounts receivable.
Patient Solutions Representative II (Healthcare Customer Service | Call Center)
R1 RCM
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Full Time
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12 hours ago
R1 RCM
Resolve patient inquiries regarding medical billing, insurance coverage, and account balances in a high-volume call center. Support patients with payment plans and utilize EMR systems to ensure first-call resolution and HIPAA compliance.
The role involves designing and maintaining semantic models and AI-powered intelligence solutions to drive financial accountability and operational efficiency. You will act as a trusted advisor to leadership, translating complex business questions into structured analytical architectures.
The role involves auditing inpatient medical records to validate DRG assignments and provide detailed rationale for findings. The auditor will use proprietary software and client EMR systems to ensure documentation improvement and reimbursement accuracy.
Identify and assess AI opportunities to drive operational efficiencies and create business value within healthcare operations. Analyze large datasets to develop AI project roadmaps and provide data-driven recommendations to stakeholders.
Lead the AI analytics product development lifecycle for the Revy product from ideation to launch. Coordinate with engineering teams and stakeholders to define the vision and prioritize the self-serve analytical AI product roadmap.
Lead the full proposal lifecycle from strategy and development to final submission for healthcare revenue cycle solutions. Coordinate cross-functional teams and stakeholders to create compelling, compliant, and competitive RFP responses.
The role focuses on analyzing customer data to identify improvement opportunities and ensuring a positive client experience through KPI monitoring. The analyst supports Customer Service Managers in managing client relationships and collaborating across internal functions to drive operational excellence.
Lead enterprise-wide cybersecurity strategy, threat operations, and risk management to protect systems, data, and client environments. The role involves modernizing security architecture and partnering with executive leadership and the Board to ensure regulatory compliance and resilience.
Conduct concurrent and retrospective reviews of inpatient medical records to improve documentation quality and accuracy. Collaborate with physicians and stakeholders to ensure appropriate severity of illness and risk of mortality are reflected for optimal reimbursement.
Serve as the technical lead for revenue cycle analytics by building scalable data products and performance reports. Conduct root-cause analyses and collaborate with executive leadership and business directors to drive data-driven decision-making.
Lead financial assessments and develop analytical models for new customer operations to drive value and optimize revenue cycle performance. Collaborate with internal and external leadership to manage pricing workstreams, budgeting, and the transition of commercial items to steady-state operations.
Responsible for setting up data feeds and processes to produce standardized financial, quality, and productivity reporting for new healthcare clients. This includes data acquisition, modeling, and quality assurance to support operational decision-making.
Review payor peer-to-peer cases to evaluate documentation for admission status and care settings. Collaborate with payor medical directors and provide written analysis to ensure compliant revenue for client facilities.
The role involves auditing inpatient medical records to validate DRG assignments and improve documentation. The auditor provides detailed rationale and evidence for findings using industry-recognized references.
The Inpatient Production Auditor is responsible for auditing inpatient cases and reviewing medical records to validate DRG assignments. They provide detailed rationale for findings and evaluate claim reimbursement potential based on coding assignments.
Drive revenue growth through new client acquisition and expansion sales of Revenue Performance Solutions within a specific region. Develop and execute strategies to build brand awareness and manage a robust sales funnel to meet annual quotas.
Represent healthcare providers in claim disputes for workers compensation, motor vehicle accidents, and other third-party liabilities. Draft complex appeals and coordinate with external counsel to recover denied claims through legal and procedural arguments.
Review outpatient coded records for accuracy and completeness while ensuring compliance with ICD-10-CM guidelines. Perform retrospective quality audits and serve as a subject matter expert to educate coding staff and improve workflow consistency.
Lead the engineering team for the Entri platform, focusing on patient scheduling and order management systems. Drive the modernization of legacy desktop applications into scalable SaaS products while managing system architecture and design.
Drive revenue growth through new client acquisition and expansion of Revenue Performance Solutions within an assigned region. Develop and execute strategies to build brand awareness and manage the sales funnel in collaboration with the Business Development team.
Lead the commercial product enablement strategy for PhareOS by translating complex AI capabilities into compelling market narratives. Own the demo strategy and create scalable enablement infrastructure to support Sales, Product, and Client Delivery teams.
Lead the cross-portfolio marketing strategy for the Phare agentic Revenue Operating System, defining the market narrative and go-to-market strategy. Act as a strategic partner to senior stakeholders to align Product, Sales, and Marketing efforts to accelerate growth and adoption.
Design and optimize consulting delivery processes to ensure seamless execution of use cases and customer objectives. Lead and mentor process consultants while providing data-driven insights and technical leadership throughout the solution lifecycle.
Lead the design and optimization of consulting delivery processes to bridge executive strategy with operational execution. Provide business case quantification, mentor solution consultants, and drive the adoption of best practices through technical and operational leadership.
The consultant bridges executive strategy with operational execution by optimizing healthcare metrics and medical coding workflows. They are responsible for translating business requirements into technical implementation plans and designing change management strategies to drive adoption.
PAS Physician Advisor (Level of Care / Admission Status Review)
R1 RCM
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Full Time
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2 months ago
R1 RCM
Proactively review inpatient cases to ensure compliant admission status and reduce the risk of denials. Engage with attending physicians and utilization review teams to discuss and determine appropriate patient status based on documentation.
Represent healthcare providers in disputes with insurance carriers by drafting complex appeals and reviewing contractual provisions. Resolve high-balance denied claims and represent clients during Administrative Law Judge hearings.
Lead the design and optimization of consulting delivery processes to bridge executive strategy with operational execution. Provide business case quantification, mentor solution consultants, and drive the adoption of best practices through technical and operational leadership.
Manage the end-to-end access lifecycle, including provisioning, modification, and deprovisioning across multiple systems. Collaborate with stakeholders to ensure compliance, drive process improvements, and resolve ServiceNow tickets within established SLAs.
Drive new business acquisition with hospitals and health systems while owning the full enterprise sales process. Build and nurture executive-level relationships and partner with Product and Marketing to refine sales messaging.
