Revenue Cycle Analyst Underpayments

R1 RCM, Inc.; Boise (ID); Remote; USD 47,000 - 72,000; Full time

Job summary

R1 RCM Inc. seeks an Underpayments Analyst to validate and review hospital accounts with potential revenue opportunity.

You will confirm claim reimbursement, identify factors impacting reimbursement, diagnose root causes of underpayments, and collaborate with support teams to resolve issues, leveraging data analysis. The role requires a Bachelor’s degree or equivalent experience, strong analytical and communication skills, and attention to detail.

Qualifications

• A Bachelor's degree or a High School diploma with 2+ years' 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
• Multiple 1-week onsite company-paid training in R1 office

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.

Skills

Hospital billing

Revenue cycle

Data analytics

Education

Bachelor's degree

High School diploma with 2+ years' experience in hospital billing/revenue cycle

Tools

R1 proprietary software

Payer portals

Job description

Remote, USA

Full time

R260000007002

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:

• A Bachelor’s degree or a High School diploma with 2+ years' 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

• Multiple 1-week onsite company-paid training in R1 office

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. (http://go.r1rcm.com/benefits)

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 (https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf)

To learn more, visit: R1RCM.com

Visit us on Facebook (https://www.facebook.com/R1RCM)

R1 is the leader in healthcare revenue management, helping providers achieve new levels of performance through smart orchestration. A pioneer in the industry, R1 created the first Healthcare Revenue Operating System: a modular, intelligent platform that integrates automation, AI, and human expertise to strengthen the entire revenue cycle. With more than 20 years of experience, R1 partners with 1,000 providers, including 95 of the top 100 U.S. health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare organizations unlock greater long-term value. To learn more, visit: https://www.r1rcm.com .