Claims Processing Operations Lead

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 Claims Processing Operations Lead, you will help improve revenue cycle outcomes for our clients by proactively monitoring accounts receivable workflows, edits and rejections while adhering to productivity and quality metrics. Using your backend revenue cycle management knowledge and data analysis skills, you will identify root cause issues and recommend claims processing corrections and system fixes. Every day you will provide analytical expertise to the revenue cycle management process while coaching team leads to identify workflow issues and providing solutions for internal teams. To thrive in this role, you must know the ins and outs of claim processing, edits, and rejections and have a strong desire to share your knowledge and expertise with your team and internal and external stakeholders.

Here’s what you will experience working as a Claims Processing Operations Lead:

• Lead team meetings and calls; prepare meeting agendas, report and analyze performance metrics; support Client Success Managers on client calls as needed

• Articulate edits and rejections and back-end system fix requests in writing

• Manage, coach, and train team leads who monitor daily workflows to ensure claims are billed timely, address any issues with a sense of urgency

• Work collaboratively and cross functionally to address requests and notes from clients and internal teams

• People leadership including timecard submission, PTO requests, and performance reviews

Required Skills:

• High school diploma or equivalent

• You’ve worked in backend revenue cycle management where you learned billing workflows and can use this knowledge to identify rejection and edit trends

• You have had direct reports and feel confident in your ability to coach and mentor

• You feel confident in your ability to navigate Cerner and healthcare claims clearinghouse

• You know how to create pivot tables in Excel to analyze data

For this US-based position, the base pay range is $47,237.00 - $78,919.86 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.This job is eligible to participate in our annual bonus plan at a target of 5.00%

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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