Jobs at R1 RCM

Provide high-trust executive administrative support to the Director, Office of the CEO: manage calendars, scheduling, travel, expense reporting, document organization, meeting logistics, and action-item tracking. Anticipate needs, handle confidential information, coordinate with ELT and external partners, and support executive events and board logistics to ensure smooth Office of the CEO operations.

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.

Monitors healthcare data workflows, validates and reconciles files, troubleshoots database and data-integration issues, performs quality audits, maintains backups, and supports operational reporting. The analyst documents procedures, communicates data discrepancies and resolutions, assists with month-end processes, and helps improve standardized workflows while protecting confidential client information.

Manages key healthcare provider client relationships for revenue cycle management services. Communicates performance and strategic priorities, partners with internal service delivery leaders, addresses risks, and develops remediation plans. Uses performance metrics and data-driven insights to improve revenue cycle outcomes, client satisfaction, retention, KLAS, and NPS results. Serves as a customer expert and change agent while supporting operational excellence and team growth.

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.

Reviews hospital accounts to identify and validate underpayments, confirms expected reimbursement, researches payer and account details, diagnoses root causes, and determines resolution actions. Documents findings to support appeals, collaborates with support teams, and meets production, accuracy, and efficiency benchmarks while using patient accounting systems, payer portals, and proprietary software.

Leads cybersecurity governance, risk, and compliance programs, with ownership of third-party cyber risk, customer security assessments, risk exceptions, and the cyber risk register. Manages a geographically distributed team, matures GRC processes, drives automation, partners with internal and external stakeholders, and reports risk trends and recommendations to senior leadership. Requires extensive cybersecurity experience, people leadership, customer-facing skills, and experience building or improving third-party risk capabilities.

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.

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

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.

Supports healthcare data interface and integration projects under senior guidance. Assists with implementation tasks, data extract solutions, troubleshooting, project organization, and client go-lives. Uses basic coding and SQL skills to review data and support integration workflows. Communicates project progress and risks, follows structured implementation processes, participates in after-hours go-live support, and provides periodic on-call coverage.

Execute complex healthcare interface and data exchange projects using Rhapsody or equivalent interface engines. Troubleshoot client integration issues, manage implementation resolution and optimization, validate data flows, support go-lives, and collaborate with internal and external stakeholders. The role requires healthcare data exchange knowledge, basic coding and SQL skills, strong communication, independent work, and periodic on-call and after-hours support.

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