Full-Time

Customer Service Representative

Posted on 12/20/2024

R1 RCM

R1 RCM

10,001+ employees

Revenue cycle management solutions for healthcare

Enterprise Software
Healthcare

Compensation Overview

$15 - $20.55Hourly

Junior

Birmingham, AL, USA

Category
Customer Support
Customer Success & Support
Required Skills
Word/Pages/Docs
Customer Service
Excel/Numbers/Sheets
Requirements
  • High School diploma or equivalent
  • At least one (1) year of experience in authorization field
  • Excellent customer service skills exhibiting good oral and written communication skills
  • Ability to type fast and accurately
  • Must be able to communicate effectively and professionally to our patients and physician offices
  • Working knowledge of medical terminology, abbreviations and anatomy
  • Advanced knowledge of Health Insurance guidelines
  • Basic Microsoft Word and Excel
  • Ability to multitask and prioritize
  • Must be self-motivated
Responsibilities
  • Initiates contact with client hospital patients via telephone using appropriate scripting to ensure the patient’s medical record is current with details such as demographics and insurance information, as needed.
  • Initiates contact with insurance companies via website, fax, or telephone using appropriate scripting to ensure the required level of benefit and pre-certification/authorization requirements are obtained.
  • Communicates with other departments as needed for order accuracy and completion.
  • Utilizes hospital EMR systems to obtain clinical information.
  • Creates timely insurance authorizations on behalf of the responsible physician office.
  • Effectively coordinates Peer to Peer discussions between Clinicians and Insurance companies.
  • Provides superior customer service to all patients, works through patient-raised issues, and recommends appropriate solutions.
  • Maintains organized, detailed summaries of prior authorization requests to support post-claim denial workflows.
  • Complete appropriate electronic forms with detailed benefit and authorization information to ensure a clean claim.
  • Identifies inaccurate plan codes and corrects in the hospital’s main frame.
  • Adheres to the guidelines set forth in the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI).

R1 RCM provides Revenue Cycle Management (RCM) solutions to healthcare providers, including hospitals and physician groups. The company uses technology to streamline financial and administrative processes, helping clients reduce costs and improve patient satisfaction. R1 RCM offers both comprehensive and targeted services for various parts of the revenue cycle, partnering with organizations through long-term contracts that often include performance-based incentives. The main goal is to enhance the patient experience while improving the financial performance of healthcare providers.

Company Stage

IPO

Total Funding

N/A

Headquarters

Murray, Utah

Founded

2003

Growth & Insights
Headcount

6 month growth

10%

1 year growth

23%

2 year growth

36%
Simplify Jobs

Simplify's Take

What believers are saying

  • R1 RCM's acquisition by TowerBrook and CD&R could enhance strategic growth opportunities.
  • The increasing demand for AI-driven RCM solutions aligns with R1 RCM's technology focus.
  • R1 RCM's comprehensive documentation is valued by clients, enhancing service credibility.

What critics are saying

  • Inconsistencies in turnaround times and accuracy may affect client satisfaction.
  • The $4.5 billion debt for acquisition could increase financial risk.
  • R1 RCM faces competition from firms like Xsolis in client satisfaction.

What makes R1 RCM unique

  • R1 RCM specializes in end-to-end Revenue Cycle Management for healthcare providers.
  • The company leverages intelligent automation to streamline financial and administrative processes.
  • R1 RCM offers performance-based contracts, aligning incentives with client financial outcomes.

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