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 our Denials & AR Lead, you will be responsible for the appropriate management of assigned accounts by resolving, calling and/or appealing denied claims. You will be the primary source of contact for most client account inquiries and will act as a leader in the absence of the department supervisor.

To thrive in this role, you must:

• Be able to draft complex and contractual appeals and letters to insurance companies.

• Provide mentoring and training of other team members.

• Have an understanding of and apply per diem, case rate and DRG payment methodologies.

• Approve and review cases for external appeal and outpatient billing.

• Be an alternate point of contact for provider status inquiries and act as a primary contact for clients regarding status of accounts.

Every day you will:

• Review and apply client contract language and rates as necessary to resolve denied claims.

• Utilize payer, provider and administrative manuals to dispute denied claims.

• Make proper notations in software systems by using the proper approved note structure.

• Follow up on all appeals, claims, letters or documentation within 20 days of submission and follow up on payments at the time of overturn letters being received.

• Ensure that all assigned accounts are appealed in a timely manner and account follow-ups are handled properly.

• Handle any RUSH cases directly.

• Assist in the completion of performance appraisals to staff.

• Approve cases eligible for clinical review through the use of computer systems.

• Assist with training new or under developing employees and provide feedback.

• Review EOB’s and provider systems to obtain payment information and apply the proper payments to accounts for billing.

• Audit accounts or projects as assigned and provide necessary feedback to the Recovery Department staff.

• Audit the work of team members to ensure they are following the proper timelines and procedures.

• Audit and review client status reports.

For this US-based position, the base pay range is $43,948.00 - $67,072.00 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 competitive benefits package. (http://go.r1rcm.com/benefits)

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 California Consent (https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf)

To learn more, visit: R1RCM.com

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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.

Headquartered near Salt Lake City, Utah, R1 employs over 29,000 people globally and is traded on the Nasdaq stock exchange under the symbol “RCM.”