The Claims Resolution Specialist will be responsible for the correction, rebilling, and collection of audited patient accounts as part of the Claims Resolution and Improvement Team. Government payers require that overpayments be returned within 6 days from the date of the identified overpayment. This position is responsible for identifying overpayments and submitting corrected claims or refunds to the appropriate payer to ensure that Asension Healthcare meets regulation requirements.

Responsibilities:

Ordering and correcting audited claims to payers within a limited time frame.

Collecting on outstanding accounts to ensure claims have been reprocessed by payers in a timely manner.

Working with facility departments or Ambulatory Coding and Reimbursement and providers to resolve coding errors.

Providing research, using bills and medical records, to validate charges.

Acting as a subject matter expert and resource to others by demonstrating an understanding of government regulations and requirements for overpaid patient account while demonstrating an understanding of charge related policies, procedures, and guidelines.

Creating daily reports to improve payment results and ensuring that corrected claims are processed by the payer within appropriate timeframes.

May complete the Medicare Quarterly report for assigned regions.

May participate in corporate audits, providing input for the development of audit objectives, scopes, and procedures.

Collaborating with team members to interpret and analyze audit results to develop corrective action plans.

Acting with minimal supervision to prepare reports for presentation to management and Intermountain leaders.

Required Qualifications:

Three years customer service experience.

One year of experience working in the PSR / Account Resolution department in a role requiring the demonstration of proficiency with policies and procedures, and competence in a wide range of department job functions and responsibilities.

Experience in a role requiring billing or collection experience within the last three years.

Experience working effectively in time sensitive situations, multi-tasking and making prompt, responsible decisions.

Experience in a role requiring strong interpersonal and problem solving skills, and the demonstrated ability to work independently and under pressure with minimal supervision and excellent organizational skills.

One year of experience using word processing, spreadsheet, database, internet and e-mail, and scheduling applications with demonstrated typing proficiency.

Demonstrated ability to embrace and manage change in a positive and supportive manner.

Demonstrated ability to communicate and problem solve issues professionally and effectively with individuals at all levels of the organization.

Demonstrated ability to think independently, evaluate situations, and take appropriate action to resolve with minimal direction

Desired Qualifications:

Medical terminology, admitting, medical billing, or insurance verification experience.

Experience leading or coordinating the work of others.

One or more years of Medicare billing and collection experience.

For this US-based position, the base pay range is $15.66 - $23.45 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. (http://go.r1rcm.com/benefits)

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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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.

Headquartered near Salt Lake City, Utah, R1 employs over 29,000 people globally and is traded on the Nasdaq stock exchange under the symbol “RCM.”