Lead cross-functional initiatives to improve revenue cycle operations and financial outcomes. Manage project plans, timelines, and resource allocations while mentoring junior team members.
R1 RCM
39 Remote Job Openings at R1 RCM
The Service Delivery Manager will develop and deliver presentations to client executives and lead analytics to communicate performance metrics. They will also identify projects to improve operational performance and collaborate with internal teams to align objectives.
Manage key client relationships and communicate revenue cycle performance to drive operational success. Partner with internal service delivery teams to optimize performance metrics and lead strategic transformations for hospital organizations.
Assigns CPT-4 and HCPCS codes to cardiovascular and interventional radiology medical records while ensuring 95% accuracy. Performs charge capture audits, reconciles surgical logs, and collaborates with clinical and finance teams to resolve billing discrepancies.
The Privacy Analyst is responsible for investigating data incidents and ensuring compliance with federal and state privacy laws, specifically regarding Protected Health Information. They will develop compliance metrics, conduct risk assessments, and collaborate with internal teams to enhance the company's privacy posture.
Monitor and validate the Healthcare AR Follow-Up workflow platform to ensure system performance and process accuracy. Analyze operational data to identify root causes of issues and partner with cross-functional teams to drive continuous improvement.
Conduct concurrent and retrospective reviews of inpatient medical records to improve documentation quality and ensure accurate reimbursement. Collaborate with physicians and stakeholders to resolve documentation ambiguities and provide education on coding guidelines.
Design and develop R1's Business Intelligence toolset using Snowflake and Power BI to create operational intelligence. Leverage AI agents and MCP integrations to accelerate development and scale the impact of the analytics platform.
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.
Design and optimize AI-enabled tools and automated workflows for Patient Access operations. Lead performance management, analyze KPIs, and partner with cross-functional teams to increase operational efficiency.
The Client Delivery Manager is responsible for building long-term customer relationships and ensuring an exceptional client experience through timely communication and issue resolution. They manage client reporting, meeting agendas, and act as the primary liaison between clients and internal operations teams.
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.
Develop and optimize automated processes and integrations between enterprise systems using AI tools and platforms like Power Automate. Collaborate with business leaders to identify automation opportunities and maintain scripts to drive process efficiency.
The role involves building and optimizing reporting solutions to turn complex revenue cycle data into actionable client insights. You will partner with internal operations and client stakeholders to identify trends, uncover defects, and drive operational execution.
Patient Solutions Representative II (Healthcare Customer Service | Call Center)
R1 RCM
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Full Time
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8 days ago
R1 RCM
Resolve patient questions 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 accurate documentation and first-call resolution.
The specialist verifies and loads patient insurance coverage into platform systems to improve billing accuracy and reduce denials. They manage coverage work queues, coordinate with payers, and serve as a liaison between clients and internal teams to optimize workflows.
Responsible for retrieving, preparing, and releasing patient records to authorized third parties while adhering to strict confidentiality and HIPAA protocols. The role also involves updating data systems, performing audits for accuracy, and handling inquiries via phone, email, and fax.
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.
Manage the end-to-end RFP process for healthcare technology prospects, from initial solution development to final submission. Collaborate with stakeholders and subject matter experts to create compelling, compliant, and high-quality proposal content.
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.
Translate business requirements into implementation artifacts and draft future-state process flows and configuration documentation. Partner with Process Engineers to support end-to-end delivery of use cases and maintain implementation trackers.
Translate business and operational requirements into solution design artifacts and future-state process flows. Partner with Process Engineers to support the end-to-end delivery of use cases and track performance via KPIs and SLAs.
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.
Analyze denied claims to identify clinical, coding, and process-driven root causes to reduce preventable revenue loss. Partner with operational and coding teams to develop problem statements and drive corrective actions to improve financial performance.
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.
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.
The role involves partnering across operational areas to drive performance by monitoring key metrics and facilitating a central operating rhythm. Responsibilities include identifying process defects, producing financial analyses, and collaborating with global teams to optimize revenue cycle efficiencies.
The Coding Integrity Specialist performs complex coding quality reviews to ensure accurate reimbursement and public reporting. They collaborate with CDI teams and hospital leadership to resolve documentation inconsistencies and identify coding trends for education.
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.
Lead the AI analytics product development lifecycle from ideation to launch while managing stakeholder requirements and cross-functional dependencies. Define the vision and roadmap for self-serve analytical AI products to deliver actionable insights for healthcare revenue cycle management.
The Physician Advisor reviews denied payer cases to evaluate documentation support for admission status and care settings. They also engage with payer medical directors to discuss authorization status and serve as a clinical resource for staff.
The Forward Deployed Process Consultant bridges executive strategy with operational execution by optimizing healthcare workflows and medical coding processes. They are responsible for designing implementation plans, monitoring KPIs, and serving as a liaison between leadership and operational teams.
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.
