Rules Associate

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 Rules Associate you will help ­­create opportunities for improved revenue generation for our clients through contract modeling and rules writing. Every day you will, write SQL-based rules using data from government and commercial payer contracts. You will develop expertise in reimbursement structures and analyze and identify payer behaviors and trends. To thrive in this role, you must have a background and experience with quantitative or analytical work. Data analytics and prior SQL query writing experience is preferred. Prior experience in hospital billing or revenue cycle is a plus but not required.

Here’s what you will experience working as a Rules Associate:

• Model hospital contracts and execute pricing in R1’s proprietary software

• Analyze commercial and government reimbursement structures

• Develop and execute specific contract-based rules to identify underpayment opportunities

• Trend and analyze data for quality assurance and to identify new, targeted pockets of inventory, which includes SQL writing and verification of results. 

• Collaborate with Global Rules team to optimize and expand rules across regions and clients. 

• Maintain strong lines of communication with validation teams, highlighting new opportunities and responding to feedback and requests. 

Required Skills:

• High school diploma, GED, or equivalent

• Prior experience working with large data sets in an employment or academic setting

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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