US-Denials & AR Analyst I

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. Description: The A/R Revenue Recovery Analyst I will be a Remote position responsible for the appropriate management of assigned accounts. This person will be responsible for calling and following up with 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: *This is not an inclusive list. Other duties may be assigned. 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. 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. 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. Required Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: Bachelor's degree from four-year college or university; or one to two years related experience and/or training; or equivalent combination of education and experience. To perform this job successfully, an individual should have knowledge. Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests. Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package. To learn more, visit: R1RCM.com. Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests. Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package including: Comprehensive Medical, Dental, Vision & RX Coverage Paid Time Off, Volunteer Time & Holidays 401K with Company Match Company-Paid Life Insurance, Short-Term Disability & Long-Term Disability Tuition Reimbursement Parental Leave 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 Visit us on Facebook R1 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 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.