Operations Associate - Pacific Time Zone

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

Job summary

Join a forward-thinking company as an Operations Associate, where you'll play a vital role in recovering underpaid hospital claims. This position offers the opportunity to utilize your communication and analytical skills while working closely with healthcare insurance companies. You'll engage in follow-up calls, document actions, and analyze data to ensure compliance and maximize reimbursement. With a supportive team environment and performance-based evaluations, you can expect opportunities for career advancement. Embrace the chance to make a meaningful impact in the healthcare sector while enjoying a competitive benefits package.

Benefits

Competitive Benefits Package

Qualifications

• Bachelor’s Degree or equivalent experience in healthcare claims.
• Strong verbal and written communication skills are essential.

Responsibilities

• Conduct follow-up calls to insurance companies regarding claims.
• Analyze denial data and develop evidence-based responses.

Skills

Communication Skills

Analytical Skills

Problem-Solving Skills

Critical Thinking

Microsoft Office Proficiency

Education

Bachelor’s Degree

High School Diploma or GED

Tools

Microsoft Outlook

Microsoft Teams

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

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, c onduct follow-up calls and portal escalations, articulate claim and contract details, and m aintain 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. This position is scheduled to start on June 23, 2025.

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

• Conduct timely and professional follow-up calls to insurance companies 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 communication and actions during payer escalation calls and payer portal reviews for reference and tracking

• Analyze denial data to develop evidence-based responses for claim and appeal denials, ensuring contractual payment

• Perform continual analysis and quality control of underpayment risk areas to ensure audit accuracy

• Collaborate with cross-functional teams and stakeholders to optimize reimbursement and identify process improvement opportunities

Required Skills:

• Bachelor’s Degree –OR- hi gh s chool diploma, GED, or equivalent with recent w ork experience in hospital billing, revenue cycle management, healthcare claims .

• Ability to communicate effectively verbally and in writing including the ability to ask the right questions and provide detailed documentation

• Ability to apply critical thinking and problem-solving skills, make informed decisions quickly and confidently, including identifying patterns, trends, and root causes

• Computer proficiency including accurate typing skills; ability to navigate Microsoft Office products (Outlook, Teams, Word, Excel, PowerPoint)

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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