Full-Time

Hospital Coding Auditor

Confirmed live in the last 24 hours

R1 RCM

R1 RCM

10,001+ employees

Revenue cycle management solutions for healthcare

Enterprise Software
Healthcare

Compensation Overview

$43.9k - $67.1kAnnually

Junior, Mid

Remote in USA

Category
Healthcare Administration & Support
Medical, Clinical & Veterinary
Requirements
  • CPC, CCS, CPC-H (COC), CPMA, CIC, RHIA, RHIT and/or CCS-P certification
  • Experience in billing, charge documentation, charge audit or charge capture activities, or other functions related to revenue cycle activities.
  • Experience coding multi-specialties preferred that may include trauma, orthopedics, cardiology, interventional radiology, and neurology.
  • Must possess a demonstrated knowledge of clinical processes; clinical coding (CPT, HCPCS, ICD-10, revenue codes, status indicators, and modifiers), charging processes and audits.
  • Knowledge of CMS guidelines, Ambulatory Payment Classification, and Outpatient Prospective Payment System, reimbursement structures and prebill edits including Outpatient Coding Edits/Correct Coding Initiative edits preferred.
  • Experience with encoder technology and electronic medical record systems.
  • Ability to work in a flexible environment, adapting to changing priorities.
  • Excellent organizational skills and strong attention to detail.
Responsibilities
  • Review hospital charges against medical record and all applicable documentation to determine appropriate code assignments on services provided (CPT/HCPCS codes)
  • Understand billing and coding requirements for government and commercial payers.
  • Abstract statistical data from the patient record and enter information following facility guidelines.
  • Follow all HIPAA regulations and uphold a higher standard around privacy requirements.
  • Maintain at least a 95% accuracy rate.
  • Maintain productivity standards, tracking logs and deadlines.

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 comprehensive services that cover all aspects of the revenue cycle, from patient registration to billing and collections. Their goal is to enhance the financial performance of healthcare organizations while allowing them to focus more on patient care.

Company Stage

Acquired

Total Funding

N/A

Headquarters

Murray, Utah

Founded

N/A

Growth & Insights
Headcount

6 month growth

12%

1 year growth

23%

2 year growth

37%
Simplify Jobs

Simplify's Take

What believers are saying

  • The acquisition by TowerBrook Capital Partners and CD&R for $8.9 billion reflects strong investor confidence and potential for growth.
  • R1 RCM's advanced RCM solutions, like R1 Professional, are widely adopted by large hospital-owned medical groups, indicating robust market penetration.
  • The company's strategic focus on automation and AI in handling clinical denials appeals positions it well to address rising healthcare financial pressures.

What critics are saying

  • The recent cyberattack and customer bankruptcy have negatively impacted R1's revenue outlook for 2024, highlighting vulnerabilities in its operations.
  • The competitive landscape in the RCM sector is intense, with potential for market share erosion by emerging technologies and new entrants.

What makes R1 RCM unique

  • R1 RCM's focus on end-to-end RCM solutions tailored for healthcare providers sets it apart from competitors who may offer more generalized financial services.
  • The company's use of intelligent automation to streamline revenue cycle processes provides a competitive edge in reducing administrative burdens and improving patient satisfaction.
  • R1 RCM's performance-based incentive contracts align its success with that of its clients, fostering long-term partnerships and trust.

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