Senior Insurance Services Specialist

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 Patient Solutions Lead, you will provide day-to-day assistance and technical support to your assigned team(s). Every day you will, liaison between the Patient Solutions team, patients, their representatives, payers, and other departments within R1RCM. This position also partners with management to standardize, develop, and update workflow processes, and monitors team productivity and quality, while working accounts to maximize reimbursement.

Here’s what you will experience working as a Senior Insurance Services Specialist:

• Assists with training and mentoring of new and current employees on policies, procedures, and systems
• Oversee employee daily work volumes, ensuring employees are meeting or exceeding department standards
• Provides feedback to management on team and individual accomplishments, areas of concern, progress, and training needs
• Ensure all escalated requests are identified, tracked, and resolved
• Ensure all inbound calls are answered and outbound call goals are achieved as outlined in policy/service level agreements.
• Review and interpret patient statements, balances, and client contractual terms/agreements
• Identify contractual and administrative adjustments
• Review all problems claims to determine reasons for, and resolution of, problems and delegates follow-up back to employee for necessary action
• Assist team and supervisor with escalated patient inquiries/concerns and resolve within 24 hours when possible
• Go-to person for employee questions and concerns and addresses them in a timely and professional manner; obtaining support from management as needed
• Back-up for all Patient Solution job duties as needed (i.e., receiving inbound calls, making outbound calls, answering questions, handling complaints)

Required Skills:

• High school diploma or equivalent
• 2+ years’ experience as Specialist, Patient Solutions, or leadership role 
• Strong understanding of patient experience/customer service requirements to include healthcare knowledge with an emphasis on patient and insurance billing
• Knowledge of EOBs, CPT & ICD-10 codes, HCFAs, UB04s, HCPCS, DRGs and authorizations/referrals
• Knowledge of computerized registration, billing, collection, and problem resolution procedures
• Electronic health record experience (Epic, Cerner, Meditech etc.)
• Strong computer skills including proficiency with Microsoft Office Suite
• Ability to navigate health plan websites to verify eligibility, benefits and claim status

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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