Offer summary

Qualifications:

Advanced analytical skills with a strong understanding of technical systems., Experience in hospital/physician coding and medical coding certification preferred., Proficiency in Microsoft Excel and T-SQL, with knowledge of CPT/HCPCS/ICD10 coding., Ability to manage multiple projects and prioritize tasks effectively..

Key responsibilities:

Oversee the maintenance and improvement of the Charge Capture Rules System.

Evaluate and manage Rules Engine performance, including monitoring PowerBI and Salesforce.

Customize the rule engine to meet client-specific needs and maintain the existing Rule Library.

Assist with client implementations and create educational materials based on QA findings.

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 a Charge Capture Rules Architect, you will help the company by overseeing the technical systems that support the Charge Capture service line. Every day, you will provide the maintenance, quality control, and improvement of the Charge Capture Rules System. You will need a strong understanding of our technical systems, an analytical and process improvement mindset, and the ability to effectively manage multiple projects at once while working in a dynamic team environment.

To thrive in this role, you must have advanced analytical skills, be comfortable effectively communicating with all levels, and have deep healthcare revenue cycle experience. This position needs someone who thrives in combining technical Excel/SQL skills and critical thinking with project-based analytical skills. The successful candidate must demonstrate organizational skills, the ability to manage time effectively and prioritize tasks independently, and have a working understanding of the hospital revenue cycle process.

Here’s what you will experience working as a Charge Capture Rules Architect:

Participation in Rules Team and Service Line revenue initiatives – planning, execution, quantification/reporting, and delivery.

Evaluate and manage Rules Engine performance including monitoring of PowerBI and Salesforce.

Maintain existing Rule Library through maintenance and net new rule creation.

Customize the rule engine to recognize client-specific practices and/or to meet client needs.

Drive inventory creation, expansion, and efficiency.

Assist in Manual Targeting, data validation, and queue management as needed.

Assist with client implementations via data validation and Rule Engine preparation.

Create Auditor Education meeting content based on QA findings and provide educational materials cross-functionally.

Required Skills:

Experience with hospital/physician coding.

Medical Coding Certification – CCS, CPC, CPC-H – preferred.

Knowledge of coding with CPT/HCPCS/ICD10 diagnosis and PCS, and medical terminology.

Understanding of hospital contracts and reimbursement methodology.

Strong computer skills, including proficiency with Microsoft Excel and T-SQL.

Strong quantitative and qualitative analytical skills.

Chargemaster Pricing Experience is a plus.

Experience or interest in LLM, AI, and/or Machine Learning is a plus.

Must be able to organize workflow, prioritize tasks, and meet deadlines.

For this US-based position, the base pay range is $69,556.00 - $114,234.05 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 10.00%

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.

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To learn more, visit: R1RCM.com

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