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.
With over 30,000 employees globally and a robust presence in India, comprising over 17,000 employees across Delhi NCR, Hyderabad, Bangalore, and Chennai, we foster an inclusive culture where every team member feels valued and empowered. Our mission is to transform the healthcare industry by driving efficiency for healthcare systems, hospitals, and physician practices, continuously striving to make healthcare work better for everyone.
Role Objective:
AR is the most essential part in the RCM cycle. It is usually the last step. After Denial management (AR), again the cycle starts till the payment is made by the insurance company.
Essential Duties and Responsibilities:
Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures.
Manage a team of 25-30 FTEs
FTEs will be directly reporting to AM
Responsible to resolve queries, account reviews and provide training in case required
Drive production and quality to the expected level
Responsible to identify production and quality issues and to put plans in place for improvement
Analyze data to identify payer issues & challenges and fixes
Should work towards team engagement and retention/absenteeism
Will be responsible to lead internal and external calls
Performance management.
First level of escalation.
Work in all shifts on a rotational basis.
Need to be cost efficient with regards to processes, resource utilization and overall constant cost management.
Must operate utilizing aggressive operating metrics.
Qualifications:
Graduate in any discipline from a recognized educational institute (Except B.Pharma, M.Pharma, Regular MCA, B.Tech & Freshers)
Good analytical skills and proficiency with MS Word, Excel and Powerpoint (Typing speed of 30 WPM)
Good communication Skills (both written & verbal)
Skill Set:
Candidate should be good in Denial Management
Candidate should have knowledge of Medicare, Medicaid & ICD & CPT codes used on Denials
Good domain knowledge
Ability to interact positively with team members, peer group and seniors.
Demonstrated ability to exceed performance targets
Ability to effectively prioritize individual and team responsibilities
Communicates well in front of groups, both large and small.