Company Profile:

R1 India is proud to be recognized amongst Top 25 Best Companies to Work For 2024, by the Great Place to Work Institute. This is our second consecutive recognition on this prestigious Best Workplaces list, building on the Top 50 recognition we achieved in 2023. Our focus on employee wellbeing and inclusion and diversity is demonstrated through prestigious recognitions with R1 India being ranked amongst Best in Healthcare, Top 100 Best Companies for Women by Avtar & Seramount, and amongst Top 10 Best Workplaces in Health & Wellness. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to ‘make healthcare work better for all’ by enabling efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 16,000+ strong in India with presence in Delhi NCR, Hyderabad, Bangalore, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities.

Job description:

What you will do:

·       To design, analyze and maintain healthcare reimbursement models to ensure the revenue estimation is in-line with the contracts.

·       To perform various analytical reviews and deep-dives (root cause analysis) on client-specific healthcare reimbursement methodology to ensure accuracy of revenue projections and actual collections.

·       To report/highlight the exceptions in reimbursement method by building contract models for Hospital charges

·       To effectively communicate the findings/ observations with recommended action to US team/clients.

·       Maintain MIS related to analysis, Accuracy and coverage report for maintenance databases

·       Handling client calls and communicating effectively for task deliverables and site maintenance

What will you need:

·     Graduate degree Preferably in Statistics\ Mathematics\ Economics\ Commerce\Finance from a reputed educational institute

·       Good analytical and algorithm building skills, having experience to build contract models for hospital charges to calculate expected reimbursement

·       Skills to read, understand and interpret reimbursement contracts between hospitals and insurance providers.

·       Experience/knowledge of various US healthcare reimbursement methods like MS DRG weightage, Multipliers, % of charges, outliers, Grouper fee schedule etc.

·       Good Communication Skills (both written & verbal)

·       Preferable - 1-3 years of experience in US healthcare

·       Having good knowledge about RCM cycle and denial management