Denials & AR Senior Analyst

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 Denials and AR Senior Analyst, you will help R1 by managing assigned accounts or clients.  Every day, you will do initial reviews, call insurance companies to resolve authorization and claim denials, write appeals and letters to insurance companies to resolve denials, and follow up on appeals to the point of exhaustion or payment. 

To thrive in this role, you must have Denials or AR experience in Hospital or Physician claims and experience working in a production-based environment is required.  We will teach you our industry-leading technology and a variety of skill sets to help you excel in your new position. You will also need experience in writing appeal letters to insurance companies.

Here’s what you will experience working as a Denials & AR Senior Analyst:

• You will be investigating and analyzing claims to identify denial reasons.

• Drafting complex and contractual appeals and letters to insurance companies.

• Utilizing strong attention to detail you will calculate expected claim reimbursement and notate accounts with updates received via email/phone from insurance companies.

• Approve cases eligible for clinical review.

• Assist with training of employees and provide necessary feedback as requested by management.

• Approve and review cases for external appeal and outpatient billing.

• Be an alternate point of contact for provider status inquiries.

• Review EOB’s and provider systems to obtain payment information and apply the proper payments to accounts for billing.

• Communicate all employee issues or potential areas of concern to department supervisor immediately. 

• Identify whether a claim has been under or over paid based on the provider’s expected reimbursement.

• Determine if underpayments are based on patient responsibility.

• Maintain an understanding of DRG, per diem, case rates and other relevant insurance reimbursement schematics.

• Apply provider specific reimbursement methodologies, payment policies and provider contracts to each payment reviewed to confirm payment in full.

• Meet all weekly performance standards and goals set by management.

For this US-based position, the base pay range is $16.88 - $24.79 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.

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To learn more, visit: R1RCM.com

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