Complex Denial Assistant
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 Complex Denial Assistant, you will assist the complex denials staff in preparing and submitting complex and contractual appeals and letters to insurance companies. Every day, you will facilitate the organization/gathering/preparing of documents to be submitted with appeals or for administrative hearings. To thrive in this role, you must maintain clear written and oral communication with internal and external parties while assisting recovery staff in pursuing appeals. Here’s what you will experience working as a Complex Denial Assistant: Investigate the facts of a denial and perform research into payor policies, state/Federal regulations, case law and precedents. Apply provider specific reimbursement methodologies, payment policies and provider contracts to confirm payment in full. Contact payors to conduct follow-up on pending appeals. Meet performance standards and goals set by management. Administrative duties or projects as assigned by Director or another member of leadership. Independently manage assigned worklist with minimal oversight in compliance with established timelines. Follow all HIPAA guidelines. Preferred Qualifications: Paralegal certification with 1 year of experience in legal, insurance, or healthcare preferred. For this US-based position, the base pay range is $46,664.00 - $72,250.29 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training. This job is eligible to participate in our annual bonus plan at a target of 5.00% 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 competitive benefits package. 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. CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent To learn more, visit: R1RCM.com Visit us on Facebook Apply To This Job