R1 is a leading provider of technology-enabled revenue cycle management services which transform and solve challenges across health systems, hospitals and physician practices. Headquartered in Chicago, R1 is publicly-traded organization with employees throughout the US and international locations. Our mission is to be the one trusted partner to manage revenue, so providers and patients can focus on what matters most. Our priority is to always do what is best for our clients, patient’s and each other. With our proven and scalable operating model, we complement a healthcare organization’s infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience. The Customer Service Representative II will be responsible for creating required insurance authorizations on behalf of the responsible physician’s office for scheduled patients. Direct patient contact may be required to secure patient’s information such as demographics and insurance information, which is needed to determine patient’s eligibility, coverage, and authorization requirements. The Customer Service Representative II will understand payer requirements and have the ability to read and understand clinical information to support the patients need for care. Success in this role is measured with the use of weekly productivity scorecards. PRN-Shift: Afternoons 3pm-11:30pm rotating weekends, holidays and on call as needed. 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). Required Qualifications: 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 Desired Qualifications: Coding/Billing experience 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. For this US-based position, the base pay range is $14.92 - $20.21 per hour . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training. Learn more about Benefits at R1 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 including: Comprehensive Medical, Dental, Vision & RX Coverage Paid Time Off, Volunteer Time & Holidays 401K with Company Match Company-Paid Life Insurance, Short-Term Disability & Long-Term Disability Tuition Reimbursement Parental Leave R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories. If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance. CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent To learn more, visit: R1RCM.com Visit us on Facebook R1 RCM is a leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems, and medical groups. Our mission is to make healthcare simpler, so providers and patients can focus on what matters most. R1’s proven and scalable operating models seamlessly complement a healthcare organization’s infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience. Our priority is to always do what is best for our clients, patients, and each other. Headquartered near Salt Lake City, Utah, R1 employs over 27,000 people globally and is traded on the Nasdaq stock exchange under the symbol “RCM.”