Denials 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 Senior Analyst, you will help R1 by managing assigned accounts or clients.  Each day could include doing initial reviews, calling insurance companies to resolve authorization and clinical claim denials, writing appeals and letters to insurance companies to resolve denials, following up on appeals to the point of exhaustion or payment and performing contract and manual reviews between payer and providers. 

Prior Hospital Denials claims experience working in a production-based environment is required.  We will teach you our industry leading technology and a variety of skillsets to help you excel in your new position. You will also need experience in writing appeal letters to insurance companies.

To thrive in this role, you must have the following skills:

• Completes basic and complex initial reviews on high dollar claims and inventory.

• Conducts complex payer follow-up via phone, portal or email.

• Writes appeals and other correspondence to payers to overturn denials or resolve payer delay with writing skills being utilized.

• Appeal follow-up to exhaustion or payment.

• Utilizes client system(s) to obtain necessary data.

• Utilize payer portals to submit appeals, documentation and inquiries and follow-up for status.

• Utilizes internal software platform for workflow documentation and tracking.

• Proficient in contractual reimbursement calculation and underpayment identification.

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

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

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

• You can expect to contact providers to learn the status of previously resubmitted claims, written appeals, or updates on incoming claims payments.

• Understands and utilize payer contracts and provider manuals.

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

• You can expect a team you can rely on, including a mentor that cares about your progress toward your career goals.

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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