Specialist at R1 Rcm in Gurugram, Haryana, India

Specialist Location: Gurugram, India R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation and workflow orchestration. With over 30,000 employees globally and a robust presence in India, comprising over 17,000 employees across Delhi NCR, Hyderabad, Bangalore, and Chennai, we foster an inclusive culture where every team member feels valued and empowered. Our mission is to transform the healthcare industry by driving efficiency for healthcare systems, hospitals, and physician practices, continuously striving to make healthcare work better for everyone. About the role: The role involves conducting audits, sharing performance reports, and creating training plans while giving feedback. It includes handling issues, working with teams to improve quality, and figuring out reason for underpayment and prepare a resolution plan. The job also requires analyzing root cause and project progress and coaching. What you will do: Will do audits as per the weekly-monthly audit plan, Participate in process & training calls as required Reports sharing to communicate performance effectively and timely with Ops and QA team. Will be actively involved in creating audit & sample plan, feedback sharing with team members, based on the themes identified. QA will be involved in weekly or monthly calibration calls with Project team. Will be actively involved in managing escalations received externally and internally Work closely with the Ops supervisors and quality team to develop analysts & team level action plans for Quality improvement. Diagnose and understand how the underpayment occurred and what our client could have done to prevent it. Work on financial analysis, reviews, and deep dives on client specific healthcare data, making sure of accuracy of revenue projections and actual collections. To call payors for underpaid charges and get status to provide correct resolution for claims for underpayment and denials. To perform various analytical reviews and deep-dives (root cause analysis) on client-specific for underpayment validation and find out better way to manage calls and target simultaneously. To effectively communicate the findings/ observations with recommended action to US team/clients. Handling client calls and communicating effectively for task deliverables and inventory/workflow management/overdue claims management. Maintaining quality for each claim and provide proper comments for observations. Should have good understanding of notes interpretation. What you will Need: Graduate in any discipline from a recognized university/college with good academic track record. Knowledge of Basic SQL, MS Excel, Power Point Excellent communication Skills (both written & verbal) Working closely and communicating effectively with internal and external stakeholders in an ever-changing, rapid growth environment with tight deadlines. Minimum 3 years of experience in US health care and 1 year of experience in Underpayment. Preferred if have EPIC experience. Strong analytical skills with emphasis on complex equations Understanding of advance technology that helps to improve process efficiency. Flexible to work in 24*7 environment. Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests. Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package. To learn more, visit: r1rcm.com Visit us on Facebook