Underpayment Specialist

R1 is a leading provider of technology-driven solutions that enhance the patient experience and improve the financial performance of hospitals, health systems, and medical groups. We uniquely combine the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, which includes sophisticated analytics, AI, intelligent automation, and workflow orchestration.

The Underpayment Specialist will be responsible for achieving annual appeal and cash targets specific to their client. This role involves reviewing accounts across all payer groups to identify recovery opportunities. Our focus is on collecting additional reimbursement owed due to payer errors by analyzing claim variances, submitting appeals to payers, and following through to resolution with payer calls and ongoing communication. The Underpayment Specialist will also participate in team meetings, escalate process issues or ideas, and collaborate with our offshore counterparts as needed. The primary responsibility is to facilitate maximum revenue for our clients by resolving underpayment issues on adjudicated insurance claims. The Underpayment Specialist will report directly to one of the team managers.

Key Responsibilities:

· Analyze claim variances using proprietary software

· Generate and submit appeals to payers

· Follow payer-specific guidelines for submissions

· Conduct follow-up calls to payers

· Monitor accounts through payment/resolution

· Achieve annual cash collection targets

· Initiate process improvements or escalate issues promptly

· Participate in team meetings and communications

Qualifications:

· HS Diploma or GED

· Strong technical skills, particularly in MS Windows-based applications

· Excellent communication skills

· Ability to work well both independently and in a team environment

Preferred Qualifications:

· Bachelor's degree or 1-2 years of experience in hospital/physician claims variance analysis

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

Visit us on Facebook

#tj2022 #li-remote #healthcare #underpayment #RIS #RCM