Senior Revenue Cycle Analyst Underpayments

This position focuses on identifying and resolving underpaid claims by researching account details using client and proprietary systems, evaluating reimbursement accuracy, and supporting appeals. The position involves diagnosing root causes of underpayments, providing feedback to support the maintenance and creation of software rules to create revenue opportunities, performing quality assurance tasks and leading teams to meet performance benchmarks.

As our Senior Associate you will support R1's mission to maximize value to our clients by providing Hospital Underpayment review and analysis. You have the primary role of validating and reviewing hospital accounts which are believed to have additional revenue opportunity who will confirm claim reimbursement, ensure there are no additional variables impacting reimbursement, diagnose the root cause of the underpayment and work with other support teams to achieve this purpose. Every day you are a subject matter expert and acts as a leader educating and mentoring the team both domestic and global. To thrive in this role, you must have experience in hospital billing, resolution, revenue cycle and/or related data analytics.

Responsibilities:

• Senior Analysts will work within the client’s Patient Accounting system, payer portals and/or websites, and will utilize R1’s proprietary software to research accounts in the work queue.
• Review opportunities created, evaluate calculation of the expected reimbursement, determine if opportunity should be pursued with payer and the action required to resolve the underpayment.
• Document the account to provide information and details to support appeal and resolution effort.
• Diagnose and understand how the underpayment occurred and what our client could have done to prevent it.
• Support opportunity creation through execution of rules in R1 software
• Lead and support teams to drive revenue opportunities
• Training and mentoring of team both domestic and global
• Meet required benchmarks for production, accuracy, and efficiency
• Complete required training courses
• Promote a supportive and positive team culture that aligns with R1’ s values
• Facilitate coordination with global teams by conducting quality assurance reviews, offering constructive feedback, and fostering an environment of open communication.
• Coordinate with HBUP Partners (Audit Strategy Team, Client Delivery, Centers of Excellence, etc.) by responding to requests timely, informing cross-team strategic prioritization, identifying areas for providing constructive feedback, and fostering an environment of open communication.

Qualifications:

• 12+ months at Cloudmed/R1, or equivalent experience in hospital billing, resolution, revenue cycle and/or related data analytics
• Demonstrates strong leadership capabilities
• Organized and analytical self-starter with strong critical thinking skills and attention to detail
• Strong communicator – verbal and written communication to give specifics and details to support claims
• Strong mathematical skills with emphasis on complex equations
• Proficient with computers and technology

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 competitive benefits package.

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.

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To learn more, visit: R1RCM.com

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