Offer summary

Qualifications:

Bachelor's Degree in a relevant field., 5-8 years of experience in healthcare operations, particularly in revenue cycle management., Expertise in healthcare billing operations is essential., Strong project management skills with a proven track record in quality and operational improvements..

Key responsabilities:

Analyze and optimize current edits in claim scrubbers to enhance processing accuracy and efficiency.

Design new edits to meet future claim processing needs based on payer policies.

Collaborate with cross-functional teams to implement optimization solutions and monitor edit performance.

Produce detailed reports and presentations to communicate findings and recommendations.

Job description

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 R37 GenAI Lab Senior Process Analyst in the Perfect Claim pillar, you will play a key role in both the assessment and optimization of existing edits and the design and implementation of future edits within a novel claim scrubber system. This position requires an analytical mindset, strong collaboration skills, and the ability to drive innovation in claim processing. To thrive in this position, you will need to be an innovative self-starter and a collaborator as you work with both external vendors and internal partners to achieve goals. You’ll use your prior experience in conceptualizing and developing products and framework to help shape the future state of work, as we build a new GenAI enabled product platform.

Here's what you will experience working as a Senior Process Analyst:

Analyze and optimize current edits in claim scrubbers to improve claim processing accuracy and efficiency.
Design new edits to address future needs, anticipating changes in claim processing requirements based on payer policies and reimbursement guidelines.
Collaborate with cross-functional teams to implement optimization solutions and new edits.
Monitor and evaluate the performance of edits, making data-driven recommendations for further enhancement.
Ensure compliance of edits with industry standards and regulations.
Conduct testing and validation to ensure new edits function accurately and effectively.
Analyze trends and patterns to predict future requirements and challenges in claim processing.
Produce detailed reports and presentations to communicate findings, analytics, and recommendations.
Travel domestically and internationally; 25-50%.

Required Qualifications:

Bachelor's Degree
5-8 years of experience in healthcare operations (i.e. revenue cycle management, provider, payer, vendor).
Expertise in healthcare billing operations.
Strong project management skills with demonstrated track records in quality and operational improvements, ability to prioritize workload, meet deadlines, and perform multiple tasks simultaneously.

For this US-based position, the base pay range is $109,118.00 - $187,269.24 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.

This job is eligible to participate in our annual bonus plan at a target of 20.00%

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.

CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent

To learn more, visit: R1RCM.com

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