Jobs at R1 RCM

Prepare, scan, index, and validate medical records and vital records; retrieve charts, reconcile missing documentation, enter/update secure databases, verify identification for birth certificates, and provide compassionate customer service while maintaining strict patient confidentiality.

Process and maintain confidential medical and vital records: receive and verify birth certificate applications, retrieve and reconcile charts, prep/scan/index records, perform quality control, update databases and spreadsheets, and provide compassionate customer service to patients, providers, and payors.

Build full-stack healthcare applications using React, Node.js, Python, TypeScript, and SQL. Partner with customers, designers, and researchers to turn AI outputs into intuitive, trustworthy workflows. Own features end-to-end, including scoping, design, implementation, deployment, and delivery, while contributing product judgment to AI-powered healthcare technology.

Build full-stack AI-powered healthcare applications using React, TypeScript, Node.js, SQL, and Python. Partner with customers, design, and research to understand workflows and deliver intuitive, trustworthy automation products. Own features end to end from scoping and design through deployment, lead larger projects amid technical complexity and ambiguity, and provide guidance to less experienced engineers.

Support privacy compliance for PHI by investigating and tracking data incidents, developing metrics and remediation plans, conducting risk assessments, educating teams on federal/state privacy laws (including HIPAA), and helping enhance the companys privacy program.

Leads analytics, reporting, data modeling, automation, AI-agent development, and quality assurance for revenue cycle operations. Creates Power BI and Excel reports, analyzes complex healthcare and operational datasets, develops scalable warehouse models, and delivers actionable insights to leadership. Uses SQL, cloud data platforms, Git, Python, and AI-assisted tools to improve reporting efficiency, accuracy, and decision support.

Reviews outpatient medical records for coding completeness, accuracy, compliance, and APC/payment opportunities. Validates CPT, HCPCS, ICD-10-CM, modifiers, and APC assignments; researches coding guidelines; provides audit feedback, coaching, and expert guidance; analyzes trends; collaborates with quality, education, denials, and coding teams; and supports revenue integrity, training, and process improvement.

As a Coding Integrity Specialist, you will conduct coding reviews, ensure proper reimbursement, collaborate with teams, and provide feedback on coding accuracy.

Manage day-to-day revenue cycle engagements, oversee billing staff performance, monitor KPIs and staffing, coordinate coding and billing service teams, resolve client escalations, develop action plans, and analyze operational and client-facing reports. The role also manages client relationships, communicates performance updates, supports customer satisfaction initiatives, approves expenses and timecards, and maintains accurate documentation across client systems and payer portals.

Reviews inpatient medical records concurrently and retrospectively to identify documentation gaps affecting severity, mortality risk, coding accuracy, reimbursement, and quality outcomes. Queries physicians, assigns working DRGs, educates providers and CDI teams, conducts mortality and PSI reviews, and collaborates with coders, auditors, and quality teams. The role requires acute-care CDI experience, an active RN license, and recent clinical experience in medical-surgical, ICU, telemetry, or emergency settings.

Educates, audits, and monitors coding teams on E/M levels, procedures, diagnosis coding, CPT, ICD-10, and HCPCS. Develops and updates coding education programs, training materials, course plans, and evaluations; identifies knowledge gaps with coding leadership; ensures auditing, quality, and compliance standards; and provides constructive feedback to coders and providers. Supports training for onshore and offshore teams across ancillary, surgical, emergency medicine, and E/M specialties.

Audit inpatient medical records for DRG validation and documentation improvement. Review accounts in proprietary software and client EMR systems, validate DRG assignments, and provide detailed rationale supported by ICD-10 guidelines, AHIMA standards, compliant-query practices, and AHA Coding Clinics.

Manages regional hospital coding operations, including team performance, productivity, quality targets, service-level agreements, workflow issues, and process improvement. Conducts coding performance reviews, coaches staff, addresses quality and compliance issues, leads resolution plans, and collaborates with customers, leadership, and quality review teams. Requires an AHIMA or AAPC coding certification and healthcare revenue cycle management experience.

Audits acute inpatient medical records to validate Diagnosis Related Group assignments and documentation improvement opportunities. Reviews accounts in proprietary software and client EMR systems, provides detailed rationales and supporting evidence, and uses ICD-10 guidelines, AHIMA standards, compliant querying practices, and AHA Coding Clinics to support findings. Requires current AHIMA credentials and at least three years of ICD-10 auditing and DRG reimbursement experience.

Reviews inpatient medical records concurrently and retrospectively to identify documentation gaps, support accurate coding and DRG assignment, and improve severity-of-illness and reimbursement outcomes. Queries physicians for clarification, conducts mortality and PSI reviews, educates providers and CDI staff, collaborates with coders and quality teams, and maintains compliance with coding, CMS, and regulatory requirements.

Reviews and interprets inpatient medical records, claims documentation, and coding information to appeal denied or underpaid claims. Applies clinical judgment to DRG downgrades and clinical validation reviews, drafts persuasive appeal letters, recommends coding changes using ICD and procedural coding guidelines, and meets compliance deadlines in a remote, production-driven environment.

Manage sales compensation, commission administration, territory planning, quota setting, and sales-planning governance. Design and model incentive plans, allocate quotas, balance territories, resolve commission issues, maintain accurate Salesforce and Workday data, and oversee related systems, controls, reconciliations, and documentation. Partner cross-functionally with Sales, Finance, HR, Legal, Accounting, and leadership to ensure financially sustainable plans, accurate payouts, effective coverage, and timely annual planning execution.

Lead forward-deployed process engineering for healthcare revenue cycle transformation: quantify ROI, design and optimize processes, mentor solution consultants, drive change management, monitor KPIs/SLAs, provide technical and operational leadership, and engage clients with data-driven insights. Up to 50% travel.

Lead assessments, design future-state workflows, and translate executive strategy into operational implementation for healthcare coding and revenue cycle. Drive process mapping, change management, KPI/SLA monitoring, training, and AI-enabled coding optimization while liaising between executives and operational teams.

The role involves delivering business case quantification, optimizing processes, mentoring teams, and ensuring client satisfaction in healthcare revenue management.