Revenue Integrity Specialist

at R1 RCM in Chicago, Illinois, United States

Job Description

As our Revenue Integrity specialist, you will be responsible for key operational functions to include charge capture, clinical billing, appeals and advanced third-party or government audits. Every day you will provide day-to-day charge review/reporting, denial support, appeals coordination, and reimbursement analysis. To thrive in this role, you must have demonstrated ownership of charge, denial, and appeals as it pertains to the identification and resolution of a health system.

Responsibilities:

+ Provide day-to-day charge review/reporting, denial support, appeals coordination, reimbursement analysis to include department level reconciliation.

+ Share trends related to billing and appeals from a clinical perspective, provide transformation recommendations with cited sources, and follow up throughout; share timely feedback, deliver professional work products, and work in a cross-functional role.

+ This role may also serve as a clinical Subject Matter Expert for regulatory and compliance as it pertains to Revenue Cycle Management (RCM).

+ Often leading key projects to include Recovery Audit Contractors (RAC) Program, Charge Description Master (CDM), Texas Medicaid (TMHP), Transfer DRG Program, and Diagnosis Related Group (DRG) Validation.

Required Qualifications:

+ Minimum 3 years’ clinical or health care work experience and/or

+ Minimum 3 years’ revenue cycle management in back-end working denials, appeals, and billing

+ Knowledge of Medical Necessity Requirement

For this US-based position, the base pay range is $15.66 – $23.45 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.”