Responsibilities:
- Initiates contact with client hospital patients via telephone using appropriate scripting to ensure the patient’s medical record is current with details such as demographics and insurance information, as needed.
- Initiates contact with insurance companies via website, fax, or telephone using appropriate scripting to ensure the required level of benefit and pre-certification/authorization requirements are obtained.
- Communicates with other departments as needed for order accuracy and completion.
- Utilizes hospital EMR systems to obtain clinical information.
- Creates timely insurance authorizations on behalf of the responsible physician office.
- Effectively coordinates Peer to Peer discussions between Clinicians and Insurance companies.
- Provides superior customer service to all patients, works through patient-raised issues, and recommends appropriate solutions.
- Maintains organized, detailed summaries of prior authorization requests to support post-claim denial workflows.
- Complete appropriate electronic forms with detailed benefit and authorization information to ensure a clean claim.
- Identifies inaccurate plan codes and corrects in the hospital’s main frame.
- Adheres to the guidelines set forth in the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI).
Required Qualifications:
- High School diploma or equivalent
- At least one (1) year of experience in authorization field
- Excellent customer service skills exhibiting good oral and written communication skills
- Ability to type fast and accurately
- Must be able to communicate effectively and professionally to our patients and physician offices
- Working knowledge of medical terminology, abbreviations and anatomy
- Advanced knowledge of Health Insurance guidelines
- Basic Microsoft Word and Excel
- Ability to multitask and prioritize
- Must be self-motivated
Desired Qualifications:
Coding/Billing experience
Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests.
Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package. To learn more, visit: r1rcm.com.
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
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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