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 be responsible for underpayment opportunity generation through contract modeling and rules writing. Every day, you will develop expertise in commercial and government reimbursement structures, SQL-based rule writing, billing and coding requirements, payer behaviors, and trending and analysis of data. Successful candidates will have demonstrated organizational skills, a strong attention to detail, the ability to manage time effectively and prioritize tasks independently.
To thrive in this role, you must have a background and experience with data analytics and prior SQL query writing experience. Prior experience in a hospital billing or revenue cycle is preferred.
Here’s what you will experience working as a Rules Associate:
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Model contracts (hospital inpatient and outpatient services) and execute pricing in R1's proprietary software.
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Critically analyze commercial or government reimbursement structures, provisions and qualifiers.
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Develop and execute targeted contract-based rules to pinpoint underpayment opportunities, which includes SQL writing and verification of results through analysis.
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Trend and analyze data for quality assurance and to develop new targeted pockets of inventory, which includes SQL writing and verification of results.
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Collaborate with Global Rules team to optimize and expand rules across regions and clients.
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Maintain strong lines of communication with validation teams, highlighting new opportunities and responding to feedback and requests.
For this US-based position, the base pay range is $43,948.00 - $67,072.00 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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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.
