Senior Revenue Cycle Analyst-Underpayments

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.  

The Senior Revenue Cycle Analyst will help validate and review hospital accounts which are believed to have additional revenue opportunity. Every day you will confirm the claim reimbursement to ensure there are no additional variables impacting reimbursement, confirm BlueCard eligibility, and initiate the process of maximizing the client’s revenue via the established void/rebill submission process. To thrive you must have experience with data mining, trending and auditing claims.

• The Senior Analyst will monitor the work queues of junior staff and collaborate with Management to outline strategy, priorities, and focus for the upcoming week(s) and month(s) to ensure progress is made in production volumes and underpayment risk does not go overlooked or become untimely.
• The Senior Analyst will lead the effort of training new Analysts and will perform QA/review accounts before moving accounts to the resolution work queue. The Senior Analyst must be available to all team members assigned to assist them with questions and concerns to ensure contracts are followed as written and do so in a positive manner. The Senior Analyst must function as an escalation point and resource for effectively researching complex claim issues.
• Upon discovery of new information, the Senior Analyst will be expected to “re-price” the account, including complex scenarios, and therefore must have an understanding of inpatient and outpatient managed care payment methodologies. (e.g., Cost Outlier, APC-based pricing, OPPS, multiple procedure reductions, line-item fee schedules, etc.).
• The Senior Analyst will be expected to assist Management with planning, short- and long- term budget forecasting, and will at times be needed to work accounts and perform the job duties of an Analyst when the client impacting milestones are at risk.

Required Qualifications

• Minimum two years of experience data mining, trending and auditing claims with accuracy expectations met
• HS Diploma
• Must have a thorough understanding of Hospital Revenue Cycle and an understanding and knowledge of medical terminology, claims billing, and inpatient and outpatient coding (e.g., MSDRG, ICD-10 diagnosis and procedure codes, CPT, HCPCS, etc.) as well as experience and knowledge with inpatient and outpatient reimbursement methodologies as well as a familiarity with managed care contracts
• 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
• 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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