Revenue Cycle Analyst Underpayments

About the role

At R1, we're transforming how healthcare works by combining nearly two decades of revenue cycle expertise with advanced technology, including analytics, AI, intelligent automation and workflow orchestration. We pair that technology with the irreplaceable expertise of our people to help hospitals, health systems and medical groups improve financial performance, simplify administrative complexity and create better experiences for patients and providers.

All Together Better defines our culture and the way we work. We're a diverse, global team united by a shared mission to make healthcare work better for all. Across technology, operations and support functions, our people bring deep expertise, empathy and ingenuity to the work we do. Here, collaboration fuels progress, adaptability sparks innovation and every voice can help shape what's next for R1 and the future of healthcare.

As our Underpayments Analyst you have the primary role of validating and reviewing hospital accounts which are believed to have additional revenue opportunity. Every day you 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. To thrive in this role, you should enjoy working with data and researching payment issues.

Responsibilities

• The Validation Associate 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.
• Meet required benchmarks for production, accuracy, and efficiency.

Required Qualifications

• Bachelor's degree with an interest in building a career in revenue cycle, healthcare operations, or data analytics.
• Candidates without a Bachelor's degree may qualify with a high school diploma or equivalent and 2+ years of relevant experience in hospital billing, resolution, revenue cycle, or data analytics.
• 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 document work completed
• Strong math skills with emphasis on complex equations
• Proficient with computers and technology
• 1-week onsite company-paid training in R1 office
• Applicants must be currently authorized to work in the United States on a permanent basis. This position is not eligible for employment-based visa sponsorship now or in the future.

Pay and benefits

For this US-based position, the base pay range is $46,664.00 - $72,250.29 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.