R1 RCM
10,000+ employees
Founded 2017
💼 Consulting
📦 Logistics
🏥 Healthcare
💰 Private Equity Round on 2024-07
Consulting • Logistics • Healthcare
R1 RCM is a leading provider of revenue cycle management solutions for the healthcare industry. With an emphasis on maximizing financial performance and optimizing patient care, R1 offers a comprehensive platform that integrates data analytics, intelligent technologies, and deep expertise in revenue cycle management. The company assists healthcare providers—ranging from hospitals and health systems to physician and specialty care practices—in capturing revenue opportunities, improving payer and patient cash flows, and ensuring compliance with government regulations. R1 is committed to driving cost reductions and revenue improvements while enhancing the patient experience. Their suite of services includes revenue recovery, clinical integrity, and regulatory navigation, making them a trusted partner for many top healthcare providers.
Coding Integrity Specialist
Job not on LinkedIn
🕒 July 29
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R1 RCM
10,000+ employees
Founded 2017
💼 Consulting
📦 Logistics
🏥 Healthcare
💰 Private Equity Round on 2024-07
Consulting • Logistics • Healthcare
R1 RCM is a leading provider of revenue cycle management solutions for the healthcare industry. With an emphasis on maximizing financial performance and optimizing patient care, R1 offers a comprehensive platform that integrates data analytics, intelligent technologies, and deep expertise in revenue cycle management. The company assists healthcare providers—ranging from hospitals and health systems to physician and specialty care practices—in capturing revenue opportunities, improving payer and patient cash flows, and ensuring compliance with government regulations. R1 is committed to driving cost reductions and revenue improvements while enhancing the patient experience. Their suite of services includes revenue recovery, clinical integrity, and regulatory navigation, making them a trusted partner for many top healthcare providers.
📋 Description
• Conduct complex coding reviews related to reimbursement, public reporting, and pay for performance. • Collaborates with the CDI team, assisting with the resolution of documentation inconsistencies, DRG variances, and CDI and internal operations to ensure KPIs, SLA, RIS, and DNFB requirements. • Ensures that the DRG or reimbursement accurately reflects the services/utilization of resources provided by the hospital to optimize the impacts of case mix index reporting. • Collaborates with hospital/client leadership to validate proper coding for appropriate reimbursement for specific service lines and technology. • Performs second level focused pre-bill and post-bill account reviews to ensure accurate coding, review for quality and risk.
🎯 Requirements
• Bachelor's or associate’s degree in HIM related fields or CCS credential is required. • Minimum 5 years of inpatient coding.
🏖️ Benefits
• competitive benefits package
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