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 Operations Associate I, you will help by working directly with healthcare insurance companies to recover underpaid hospital claims for our clients. In this role, Operations Associates work directly with Validation and Client Delivery team members to obtain necessary information for account resolution. Every day you will perform resolution analysis which includes reviewing managed care contracts, state or federal legislation, claims billing, and clinical information to effectively reconcile underpaid accounts. To thrive in this role, you must meet monthly project goals and maintain current resolution efforts on all their assigned projects.
This is an excellent opportunity to work in a professional setting with a comprehensive in-house training program. The position also provides performance-based evaluations with opportunity for advancement.
This is a hybrid position located in the greater Atlanta, GA area with in-office expectations during the initial onboarding period and as needed thereafter.
Here's what you will experience working as an Operations Associate I:
- Conduct follow-up calls & payer portal escalations with insurance payers to resolve underpaid hospital claims and maximize reimbursement for hospital clients
- Maintain timely, professional follow-up and demonstrate a wide knowledge base on a variety of risk areas and contractual underpayment issues
- Analyze and interpret denial data to develop evidence-based responses for claim/appeal denials to ensure contractual payment of submitted claims
- Perform continual analysis and quality control of underpayment risk areas to ensure audit accuracy
- Analyze payer trends and patterns identified during payer interactions identify opportunities for process improvement and implement effective solutions
Required Skills
- A bachelor's degree in healthcare administration, Business, or related field or High School diploma with 2+ years of experience in revenue cycle management, billing, or healthcare finance.
For this US-based position, the base pay range is $15.00 - $22.64 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 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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