Operations Associate - Pacific Time Zone

R1 RCM; United States; On-site; USD 10,000 - 60,000; Full time

Job summary

An established industry player is seeking an Operations Associate to enhance the patient experience and improve financial performance in healthcare. This role involves direct interaction with healthcare insurance companies to resolve underpaid claims through effective communication and problem-solving. You will analyze denial data, document communications, and collaborate with teams to optimize reimbursement processes. Join a dynamic team that values innovation and offers a competitive benefits package while making a meaningful impact in the healthcare sector. If you are passionate about healthcare and eager to contribute to a transformative mission, this opportunity is perfect for you.

Benefits

Competitive benefits package

Opportunities for advancement

Performance-based evaluations

Flexible working hours

Qualifications

• High School diploma or equivalent required; medical billing education preferred.
• Strong communication and analytical skills are essential for success.

Responsibilities

• Conduct follow-up calls to resolve underpaid hospital claims.
• Analyze denial data to develop responses for claim denials.

Skills

Communication Skills

Data Analysis

Problem-Solving Skills

Healthcare Billing Knowledge

Microsoft Word

Microsoft Excel

Education

High School diploma or GED

Post-secondary education in medical billing or coding

Tools

Microsoft Word

Microsoft Excel

Job description

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, you will help recover underpaid hospital claims by working directly with healthcare insurance companies. Every day you will conduct follow-up calls and portal escalations, articulate claim and contract details, and maintain timely resolution actions with insurance payers to effectively reconcile underpaid hospital claims. To thrive in this role, you must use your communication, analysis, and problem-solving skills to meet monthly project goals and maintain current resolution efforts on all assigned projects. The position also provides performance-based evaluations with opportunity for advancement.

Please note the scheduled work hours for this position are 8 AM- 5 PM Pacific Time. Candidates based in Pacific and Mountain time zones are encouraged to apply.

Here’s what you will experience working as an Operations Associate:

• Conduct follow-up calls and escalate issues with insurance payers to resolve underpaid hospital claims, maximizing reimbursement.
• Maintain professional follow-up, demonstrating knowledge of risk areas and contractual underpayment issues as well as payer policies, guidelines, and regulations to ensure compliance and maximize reimbursement.
• Document all communications and actions during payer escalations for reference and tracking.
• Analyze denial data to develop evidence-based responses for claim and appeal denials, ensuring contractual payment.
• Collaborate with cross-functional teams and stakeholders to optimize reimbursement and identify process improvement opportunities.

Required Skills:

• High School diploma, GED, or equivalent.
• Work experience in healthcare billing or completed post-secondary education in medical billing or coding.
• Ability to communicate effectively verbally and in writing, including the ability to ask the right questions and provide detailed documentation.
• Ability to analyze data, identify patterns and trends, and make informed decisions quickly and confidently.
• Computer proficiency including accurate typing skills; ability to navigate Microsoft Word and Excel.

For this US-based position, the base pay range is $16.29 - $20.36 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.

CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent.

To learn more, visit: R1RCM.com

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R1 RCM Inc. is an American revenue cycle management company servicing hospitals, health systems and physician groups across the United States.