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.

Verify insurance coverage, eligibility, and authorization requirements; submit and follow up on pre-certification and retro-authorization requests; collaborate with clinical teams to obtain documentation; accurately document benefits in electronic records; correct insurance plan codes; notify payers of admissions; maintain HIPAA compliance and meet productivity and quality targets.

Founding sales-intelligence analyst building data models, scoring/prioritizing account opportunities, packaging analysis for non-technical stakeholders, presenting to sales leadership, and iterating with sales and operations to drive pipeline growth.

Lead end-to-end implementations of Phare OS (initially Phare Audit), managing data onboarding, ingestion, validation, and technical readiness. Serve as primary technical liaison with client IT, build repeatable implementation playbooks, coordinate cross-functionally with Product/Engineering/Commercial/Data teams, and report implementation health to senior leadership.

Maintain and audit the hospital charge master to ensure accurate charge capture and reimbursement. Perform charge capture audits, validate CPT/HCPCS coding, analyze billing data and denials, recommend CDM and workflow fixes, and collaborate with clinical and finance teams. Use Excel and clinical/coding knowledge to monitor regulatory and payer changes and support system upgrades and pricing reviews.

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.

Translate business requirements into implementation artifacts, document current and future-state workflows, and support end-to-end delivery of use cases. Assist with implementation plans, stakeholder communications, training, change management, go-live stabilization, KPI/SLA tracking, and post-implementation reviews. Maintain trackers, issue logs, and support continuous improvement. Role may require extensive travel to client sites.

Design and optimize consulting delivery processes, quantify use case ROI, lead and mentor consultants, develop roadmaps and change management, provide technical/product leadership, monitor KPIs/SLAs, and ensure continuous improvement. Role requires frequent customer engagement and significant travel (50%+).

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

Represent healthcare providers in disputes over workers' compensation, motor vehicle accident, third-party liability, and VA claims. Draft complex appeals and correspondence, apply state-specific statutes and lien laws, coordinate with external counsel, train recovery staff, and develop strategic legal and procedural approaches to recover denied claims efficiently.

Review outpatient clinical documentation to accurately assign ICD-10-CM, HCPCS and CPT-4 codes; perform retrospective quality audits; identify and correct coding errors; support reporting, education, and performance improvement; maintain coding guideline knowledge and compliance.

Lead a team building the Entri scheduling and order management platform. Drive architecture, modernize legacy desktop apps into scalable SaaS, design and deliver distributed microservices, mentor engineers, partner with product and cross-functional teams, and resolve complex production issues to improve patient scheduling and coordination.

The Physician Advisor reviews denied authorization cases, evaluates documentation, advises on request appropriateness, and engages with payor medical directors, serving as a clinical resource for staff.

The Forward Deployed Process Consultant will bridge executive strategy with operational execution in healthcare, focusing on process optimization and stakeholder communication. Responsibilities include translating business requirements, collaborating on solutions, and monitoring performance metrics.

Lead commercial product enablement for PhareOS by turning complex AI-native capabilities into clear buyer narratives, defining demo strategy, supporting strategic deals, and building scalable enablement programs and materials across Sales, Product, Client Delivery, and Marketing.

Translate operational requirements into solution designs, process maps, and implementation plans. Conduct current-state assessments, support implementation and stabilization, define KPIs/SLAs, manage stakeholder communications, change management, and risk/issue mitigation while partnering with process engineers and cross-functional teams.

The RVP of Sales will drive revenue growth through client acquisition and expansion by executing strategies, forecasting sales, and collaborating with internal teams.

As a Complex Denials Consultant, you will counsel healthcare providers in disputes with insurance carriers, handle appeals, and ensure compliance with regulations.