Job Information
R1 RCM Hospital Follow-Up Associate II in Salt Lake City, Utah
R1 RCM Inc. is a leading provider of technology-enabled revenue cycle management services which transform and solve challenges across health systems, hospitals and physician practices. Headquartered in Chicago, R1® is a publicly traded organization with employees throughout the US and international locations.
Our mission is to be the one trusted partner to manage revenue, so providers and patients can focus on what matters most. Our priority is to always do what is best for our clients, patients and each other. With our proven and scalable operating model, we complement a healthcare organization’s infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience.
As our Follow Up Associate- II , you will be responsible for investigating and examining hospital accounts, will apply appropriate methods and techniques as established internally to resolve applicable issues, follows through with unresolved accounts, provides feedback to the appropriate staff on where the process went wrong, and keeps staff educated on all current trends in the appeals arena. In addition, this position is required to learn how to conduct research analysis and work closely with third party payers to answer relevant questions and obtain appropriate information in pursuit of resolving unpaid claims.
Every day in this role you will:
Investigates and examines source of hospital denials utilizing knowledge of charge master, AS4, ICD-9 coding, CPT coding and EDI billing.
Reads and interprets expected reimbursement information from EOB's and learns legal parameters pertaining to all State and Federal Laws that pertain to the plan benefits pertaining to the EOB.
Works closely with third party payers to resolve unpaid claims in proving medical necessity of the patient's admission.
Works with HIM and PAS across the enterprise in resolving adverse benefit determinations.
Work closely with Appeals staff (Letter writers, Case Managers and Hearing specialists) in obtaining all pertinent information in a timely manner.
To thrive in this role, you must have:
Experience working with Epic EMR system
Hospital billing experience
Demonstrated extensive knowledge in the health insurance industry (Commercial Insurances, Medicare, Medicaid); health claims billing and/or Third-Party contracts
Demonstrated excellent analytical, fact-finding, problems solving and organizational skills as well as the ability to communicate, both verbally and in writing with staff, patients, and insurance plan administrators.
High School diploma
For this US-based position, the base pay range is $15.45 - $24.29 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. (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
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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.
Headquartered near Salt Lake City, Utah, R1 employs over 29,000 people globally.