Employer: R1 RCM
Shift Days: Monday- Friday, Shift Hours Span: 7:00AM-6:00PM CST, Occasional Holidays
R1 RCM Inc. is a leading provider of technology-enabled revenue cycle management services which transform and solve challenges across health systems, hospitals, and physician practices. Headquartered in Chicago, R1 is a publicly traded organization with employees throughout the US and international locations.
Our mission is to be the one trusted partner to manage revenue, so providers and patients can focus on what matters most. Our priority is to always do what is best for our clients, patients and each other. With our proven and scalable operating model, we complement a healthcare organization’s infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience.
The Payor Peer to Peer / Denials Management Support position will be primarily responsible for non-clinical work related to Payor Peer to Peer workflow. The objective of the Payor Peer to Peer service is to contact payors for medical discussions of a concurrent clinical denial. This position will assist in contacting the payor in a timely fashion to schedule and / or resolve Payor Peer to Peer cases and all other non-clinical duties related to the workflow and resolution of cases.
Additionally, this position will have responsibility to the Denials Management program. This can involve thoroughly reviewing, packaging, and submitting required documents for a prepared appeal.
In order to be successful in this role, the professional will need documentation and communication skills. Attention to detail is of paramount importance. The ability to work in multiple programs simultaneously is required. This person will be responsible for working concurrent and post bill denials in a variety of ways including but not limited to calling payors, fax, mail or courier and online portals.
Responsibilities:
- Making initial contact to payors to coordinate Payor Peer to Peer activities
- Completing follow up calls to payors in attempt to resolve Payor Peer to Peer cases
- Managing workflow in a way that promotes timely and quality success for clients
- Formatting appeals to be submitted to various payors
- Submit appeals to various payors in accordance with specific facility protocols
- Navigate PAS portal, R1 software suite and combined use of other online tools/software and resources
- Adhere to established workflow based on client and payor protocols
- Perform other duties as assigned
Required Qualifications:
- High School Diploma
- Excellent oral and written communication skills
- Proficiency in MS Excel & MS Word; excellent computer skills
Desired Qualifications:
- Bachelor’s degree preferred
Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration, and the freedom to explore professional interests.
Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package including:
- Comprehensive Medical, Dental, Vision & RX Coverage
- Paid Time Off, Volunteer Time & Holidays
- 401K with Company Match
- Company-Paid Life Insurance, Short-Term Disability & Long-Term Disability
- Tuition Reimbursement
- Parental Leave