Claims Administrator

As our Claims Administrator, you will investigate and examine denial accounts using established methods to resolve issues. Every day, you will apply appropriate methods and techniques as established internally to resolve applicable issues, follows through with unresolved accounts, and provide feedback to leadership.

You will utilize your computer skills to be able to trouble-shoot issues as they arise within the assigned specialization group. Having an analytical mindset will aide you in conducting research analysis to seek and obtain appropriate information in determining overpayments on accounts.

Having prior experience in healthcare billing and claims will provide you with an advantage in comprehending the department. We will teach you our industry-leading technology and a variety of medical terminology to perform at your best and feel good about what you do.

Here's What You Can Expect:

• Investigates and examines source of denials utilizing knowledge of charge master, AS4, ICD-9 coding, CPT coding and EDI billing.

• Reads and interprets expected reimbursement information from EOB's and learns legal parameters pertaining to all State and Federal Laws that pertain to the plan benefits pertaining to the EOB.

• Works closely with third party payers to resolve unpaid claims in proving medical necessity of the patient's admission.

• Works with HIM and PAS across the enterprise in resolving adverse benefit determinations.

• Submits technical appeals and understands the CAU scope document.

• Maintains and follows all HIPAA and confidentiality requirements.

Required Qualifications

• High School diploma

• Demonstrated excellent analytical, fact-finding, problems solving and organizational skills as well as the ability to communicate, both verbally and in writing with staff, patients, and insurance plan administrators

• Demonstrated ability to work successfully in a team setting.

For this US-based position, the base pay range is $14.92 - $20.21 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

To learn more, visit: R1RCM.com

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