As Operations Associate I in our Revenue Recovery Practice, you will leverage your experience and expertise in complex Medicare Advantage payor methodology, payment screenings and experience maneuvering through various Patient Accounting systems to deliver quality work products to R1’ s clients. The Medicare Advantage Analyst is primarily responsible for researching underpayments as they relate to Medicare Advantage payor population and researching processing issues, examining denials, and confirming payment information with the payor or within the various client patient accounting systems to determine the appropriate discharge disposition/increases in reimbursement.

REQUIRED QUALIFICATIONS:

• High School diploma.
• 1-3 years of experience specific to business analytics in an acute hospital setting or other relevant field.
  For this US-based position, the base pay range is $16.29 - $20.36 per hour . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.
  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

• Abstract information from Medical Records of Managed Care claims for accurate discharge status information on all managed care claims.
• Research medical records for post-acute care, and verify of accurate discharge status information.
• Compile supporting documentation from follow-ups with payors and research that was conducted.
• Research and communicate with post-acute care agencies to verify accurate discharge status information.
• Accurately track workflow and pipeline projects.
• Perform other duties as assigned.
• Utilization of various PA systems for payment screenings and claim research.
• Maintain constant communication with Project Managers and/or clients regarding data acquisitions, deliveries, and rebilling confirmations.
• Generate and submit reconciliation reports.
  Ensure payer follow-ups are completed through payment collection.