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 Revenue Cycle Analyst, you will help the Appeals team investigate and examine denial accounts, so they can apply appropriate methods and techniques as established internally to resolve applicable issues. Everyday you will follow through with unresolved accounts, provide feedback to the appropriate staff on errors, and educate staff on all current trends in the appeals arena. In addition, this position is required to learn how to conduct research analysis and work closely with third party payers to answer relevant questions and obtain appropriate information in pursuit of resolving unpaid claims. You will work within the client's patient accounting system, payer portals, and/or websites, and utilize R1 proprietary software to research accounts in the work queue. To thrive in this role, Revenue Cycle Analyst incumbents must be assessed as being resourceful and having extensive knowledge in area applicable to the assigned specialization group. Acts under direct supervision while learning to make complex decisions within the scope of this position.

Here’s what you will experience working as our Revenue Cycle Analyst:Investigates and examines source of denials utilizing knowledge of charge master, AS4, ICD-9 coding, CPT coding and EDI billing.Reads and interprets expected reimbursement information from EOB's and learns legal parameters pertaining to all State and Federal Laws that pertain to the plan benefits pertaining to the EOB.Works closely with third party payers to resolve unpaid claims in proving medical necessity of the patient's admission.Manage payer AR inventory for several payers and acute hospitals, communicating trends, issues, and initiatives to resolve all accounts. Diagnose and understand why the denial occurred and what is needed to both prevent if from happening in the future and how to properly resolve it with the payer. Resolve open insurance AR, handing-off accounts for clinical appeal letter submissions, calling payers to escalate denial trends, and pulling Medical Records for payer submission. 
Required Skills:Background knowledge in Medicare or Medicare HMO payersDemonstrated extensive knowledge in the health insurance industry (Commercial Insurances, Medicare, Medicaid); health claims billing and/or Third-Party contracts, minimum of two years experience in a specified area.Meet required benchmark for production, accuracy, and efficiency. Experience working with Cerner or MeditecDemonstrated excellent analytical, fact-finding, problems solving and organizational skills as well as the ability to communicate, both verbally and in writing with staff, patients, and insurance plan administrators.Demonstrated ability to work successfully in a team settingFor this US-based position, the base pay range is $45,926.00 - $70,631.44 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.

This job is eligible to participate in our annual bonus plan at a target of 5.00%

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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