This role supports a front-end application critical to coverage and eligibility verification, configuration management, and automation within the revenue cycle. You'll work deeply with business rules and real-time eligibility (RTE) — where your decisions directly impact denials, clients, and patients. You'll collaborate cross-functionally with product, engineering, operations, denials, payer services, patient access, and offshore teams.
Responsibilities:
- Read, interpret, and act on automated RTE responses tied to coverage and authorization outcomes
- Perform root-cause analysis on coverage, eligibility, and business rule issues through resolution
- Manage business rule configuration, understanding downstream impact on denials and patients
- Collaborate across product, engineering, operations, coverage/eligibility, payer services, PMT, FCC, and tech deployment
- Support current book of business and new client implementations
- Write user stories with clear acceptance criteria
- Use SQL for data analysis and troubleshooting
- Create and maintain SOPs and documentation, leveraging AI tools where possible
- Monitor production environments and coordinate troubleshooting with vendors and internal IT
- Communicate with customers and stakeholders via ticketing systems, email, and meetings
Required Qualifications:
- Real-time eligibility (RTE) experience — must be able to interpret automated eligibility responses
- Medical insurance knowledge — coverage logic, eligibility, and downstream revenue cycle impact
- SQL — querying, joins, tables, basic functions
- Ticketing system experience (ServiceNow, ServiceDesk, or comparable)
- Strong analytical skills and independent problem-solving ability
- Detail-oriented with a quality-first mindset
- Effective communicator across technical and non-technical teams
Nice to Have:
- Advanced Excel skills
- Healthcare application support or revenue cycle experience
- Experience supporting new client implementations
- Interest in AI tools for process improvement and documentation
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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Skills Required
- Real-time eligibility (RTE) experience
- Medical insurance knowledge
- SQL experience for querying and analysis
- Experience with ticketing systems
- Strong analytical skills
- Detail-oriented with a quality-first mindset
- Effective communication skills across teams
R1 RCM Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about R1 RCM and has not been reviewed or approved by R1 RCM.
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Leave & Time Off Breadth — Flexible or unlimited PTO, paid holidays/vacation, and paid volunteer time are highlighted, supporting work-life balance in many roles. Time-off usability is described as workable in many teams, especially in exempt roles.
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Flexible Benefits — Remote work options and flexible schedules are available for many positions, offering convenience and adaptability depending on role and location. Work-from-home eligibility varies by position but is called out as a valued option.
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Career-Linked Recognition & Rewards — Recognition programs such as R1 Stars are implemented to boost engagement and morale. Feedback suggests these programs help reduce turnover and provide acknowledgment beyond base pay.
R1 RCM Insights
What We Do
R1 is a leading provider of technology-driven solutions that transform the patient experience and financial performance of healthcare providers R1’s proven and scalable operating models seamlessly 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.
