R1 RCM is a leading provider of revenue cycle services and physician advisory services to healthcare providers. We help transform and manage the commercial infrastructure of care organizations. 

About the role:  

Needs to work closely and communicate effectively with internal and external stakeholders in an ever-changing, rapid growth environment with tight deadlines. This role involves designing   and analyzing the healthcare reimbursement model. Be able take up new initiatives, maintain synchrony in the team. Collaborate with external & internal stakeholders, work effectively in a growing team, be a strong team player. Be able to create and define SOP’s, TAT’s for ongoing and upcoming projects. 

What you will do:  

To design, analyze and maintain healthcare reimbursement models to ensure the revenue estimation is in-line with the contracts.  

To perform various analytical reviews and deep-dives (root cause analysis) on client-specific healthcare reimbursement methodology to ensure accuracy of revenue projections and actual collections. 

To report/highlight the exceptions in reimbursement method by building contract models for Hospital charges 

To effectively communicate the findings/ observations with recommended action to US team/clients.  

Maintain MIS related to analysis, Accuracy and coverage report for maintenance databases 

Handling client calls and communicating effectively for task deliverables and site maintenance 

 
What will you need:  

Graduate degree Preferably in Statistics\ Mathematics\ Economics\ Commerce\Finance from a reputed educational institute 

Good analytical and algorithm building skills, having experience to build contract models for hospital charges to calculate expected reimbursement 

Skills to read, understand and interpret reimbursement contracts between hospitals and insurance providers. 

Experience/knowledge of various US healthcare reimbursement methods like MS DRG weightage, Multipliers, % of charges, outliers, Grouper fee schedule etc. 

Good Communication Skills (both written & verbal) 

Preferable - 1-3 years of experience in US healthcare 

Having good knowledge about RCM cycle and denial management 

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

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