The Billing Specialist is responsible for supporting the back-end billing function for R1 RCM (R1) client sites across the United States. Reporting directly to the Billing Operations Team Lead/Manager of CBO, The primary goal is to ensure maximum revenue for our clients. With strong attention to detail and the ability to think outside the box.
The Billing Specialist would possess the knowledge and skill to deliver top services by fixing claim rejection errors, resolving any claim edits, working all relevant billing reports and responding to inquiries from various hospital billing service sources. As a strong working resource, you will partner with other key departments to ensure all back-end billing functions are maintained and adhere to R1’s productivity and quality metrics.
Your day to day role will include:
- Work first hand on actively reviewing patient accounts ensuring claims are accurate and billable.
- Identify and resolve claim edits through understanding of billing guidelines and payer requirements.
- Proactively fix claim rejection errors and resubmit claims based on payer requirements.
- Initiate contact and respond to inquiries from a various external sources.
- Comply with all Government and Third party payers regulatory mandated requirements for billing and collections.
- Answer questions and assist patients in regards to billing issues as needed(minimal).
- Ability to maintain confidentiality of all information under HIPPA guidelines.
- Other duties as assigned.
- High School Diploma or equivalent.
- Understanding how to read an EOB (Explanation of Benefits).
- Computer literacy skills, including Excel spreadsheets and Microsoft Office products.
- Enhanced communication and customer service skills.
- Ability to be self-directed, coupled with exemplary time management skills and the ability to simultaneously manage multiple tasks.
It would be great if you also have:
- Experience and working knowledge of UB-04 claim forms.
- Experience with patient billing editing systems.
- Understanding of the entire revenue cycle process.
- Knowledge of Revenue and ICD coding language.
- 1-2 years of billing experience in a facility setting.
- Knowledge of Medicaid/Medicare billing regulations.
R1 RCM (R1) is changing healthcare by infusing operational discipline and proprietary technology in hospital financial processes. We are an industry leader; we are the only independent organization with a comprehensive service and technology offering for hospital revenue cycle management, and we have achieved leading outcomes for our customers.
- A strong financial performing, growing organization that will keep you on your toes with new ideas, changes and opportunities to learn and grow in abundance. A culture of excellence, driving customer success so they can focus on improving patient care and on giving back to the community.
- A Total Rewards package which may include such things as: competitive compensation package, the ability to choose from a comprehensive benefit program mostly funded by R1 that includes medical, dental, vision, flexible spending accounts, commuter benefits, life and disability insurance, along with work life balance programs including paid time off for personal time, illness and volunteering, and we offer a retirement savings plan and continuing training and development and so much more!
Sound like you? Let’s talk!
About R1 RCM:
R1 is a leading provider of revenue cycle management services and Physician Advisory Services to healthcare providers. We are the largest independent end-to-end revenue cycle provider and have the longest operating history in the revenue cycle industry. R1’s objective is to be the one trusted partner to manage revenue so providers and patients can focus on what matters most. Our distinctive operating model and values includes people, processes, and sophisticated integrated technology/analytics that help customers realize sustainable improvements in their operating margins and improve the satisfaction of their patients, physicians, and staff. We are dedicated to transforming the commercial infrastructure and patient experience in healthcare.