Recovery Analyst - R1 RCM
Salt Lake City, UT
About the Job
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.
The A/R Revenue Recovery Analyst I is responsible for the appropriate management of assigned accounts. Responsibilities include calling insurance companies to resolve authorization and claim denials, writing appeals and letters to insurance companies to resolve denials, and following up on appeals to the point of exhaustion or payment.
Essential Duties and Responsibilities
+ Resolve, call and/or appeal a defined number of accounts per day as instructed by leadership.
+ Complete Initial Reviews and Validations as assigned.
+ Draft appeals and letters to insurance companies.
+ Calculate expected claim reimbursement.
+ Make proper notations in software system on all accounts.
+ Understand and utilize payer contracts and provider manuals when disputing denials.
+ Use proper approved note structure when notating all accounts.Insurance company name @ number dialed | First name and last initial of the representative spoken to. (Ex. Aetna @ 1-800-624-0756 | John S.)
+ Follow up on all appeals, claims, letters, or other documentation within 20 days or less of the submission.
+ Follow up on all payments at the time an overturn is received.
+ Demonstrate an understanding of office workflow by completing necessary required fields correctly.
+ Use available resources appropriately, including but not limited to training materials, shared drive, team meeting notes, etc.
+ Ensure that assigned accounts are appealed timely using an internal worklist.
+ Maintain worklist through daily audits and the open task report.
+ Ensure that all assigned cases have a follow up and that there are no duplicate follow ups.
+ Address all follow ups promptly.Alerts must be addressed within a day of receipt.Initial call requests must be addressed within two days from the receipt of the follow up.Follow ups should never be more than 14 days old.
+ Handle RUSH cases appropriately.A RUSH is any appeal or submission that is due within two weeks from the date the due date was verified.
+ Maintain one follow up in each assigned account and refrain from unnecessary duplicate follow ups on worklist.
+ Obtain prior approval from a Lead, Supervisor, or Manager for all modifications to a UB-04; including, but not limited to, additions, changes or removals to/from the original claim provided by the facility.
+ Follow all HIPAA guidelines in accordance with Employee Handbook.
For this US-based position, the base pay range is $14.69 - $21.27 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
Visit us on Facebook (https://www.facebook.com/R1RCM)
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 and is traded on the Nasdaq stock exchange under the symbol “RCM.”
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.
The A/R Revenue Recovery Analyst I is responsible for the appropriate management of assigned accounts. Responsibilities include calling insurance companies to resolve authorization and claim denials, writing appeals and letters to insurance companies to resolve denials, and following up on appeals to the point of exhaustion or payment.
Essential Duties and Responsibilities
+ Resolve, call and/or appeal a defined number of accounts per day as instructed by leadership.
+ Complete Initial Reviews and Validations as assigned.
+ Draft appeals and letters to insurance companies.
+ Calculate expected claim reimbursement.
+ Make proper notations in software system on all accounts.
+ Understand and utilize payer contracts and provider manuals when disputing denials.
+ Use proper approved note structure when notating all accounts.Insurance company name @ number dialed | First name and last initial of the representative spoken to. (Ex. Aetna @ 1-800-624-0756 | John S.)
+ Follow up on all appeals, claims, letters, or other documentation within 20 days or less of the submission.
+ Follow up on all payments at the time an overturn is received.
+ Demonstrate an understanding of office workflow by completing necessary required fields correctly.
+ Use available resources appropriately, including but not limited to training materials, shared drive, team meeting notes, etc.
+ Ensure that assigned accounts are appealed timely using an internal worklist.
+ Maintain worklist through daily audits and the open task report.
+ Ensure that all assigned cases have a follow up and that there are no duplicate follow ups.
+ Address all follow ups promptly.Alerts must be addressed within a day of receipt.Initial call requests must be addressed within two days from the receipt of the follow up.Follow ups should never be more than 14 days old.
+ Handle RUSH cases appropriately.A RUSH is any appeal or submission that is due within two weeks from the date the due date was verified.
+ Maintain one follow up in each assigned account and refrain from unnecessary duplicate follow ups on worklist.
+ Obtain prior approval from a Lead, Supervisor, or Manager for all modifications to a UB-04; including, but not limited to, additions, changes or removals to/from the original claim provided by the facility.
+ Follow all HIPAA guidelines in accordance with Employee Handbook.
For this US-based position, the base pay range is $14.69 - $21.27 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
Visit us on Facebook (https://www.facebook.com/R1RCM)
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 and is traded on the Nasdaq stock exchange under the symbol “RCM.”
Source : R1 RCM
