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.
As our Follow-up Associate you will help with investigating and examining denial accounts Every day you will,. will apply appropriate methods and techniques as established internally to resolve applicable issues, follows through with unresolved accounts, provides feedback to the appropriate staff on where the process went wrong, and keeps staff educated on all current trends in the appeals arena. To thrive in this role you must, demonstrate excellent analytical, fact-finding, problems solving and organizational skills as well as the ability to communicate, both verbally and in writing with staff, patients, and insurance plan administrators. Demonstrated ability to work successfully in a team setting.
Here’s what you will experience working as a Follow-up Associate:
- Investigates and examines source of denials utilizing knowledge of charge master, AS4, ICD-9 coding, CPT coding and EDI billing.
- Reads and interprets expected reimbursement information from EOB’s and learns legal parameters pertaining to all State and Federal Laws that pertain to the plan benefits pertaining to the EOB.
- Works closely with third party payers to resolve unpaid claims in proving medical necessity of the patient’s admission.
- Performs duties as given by supervisor to fill in where needed: covering phones, sorting mail, scanning and filing or any other office function within the CAU.
Maintains and follows all HIPAA and confidentiality requirements.
Required Qualifications:
- High School diploma
- Demonstrated extensive knowledge in the health insurance industry (Commercial Insurances, Medicare, Medicaid); health claims billing and/or Third-Party contracts
- Minimum of two years’ experience in a specified area.
For this US-based position, the base pay range is $15.45 – $24.29 per hour . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.
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