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.
Position Summary:
Applies CPT-4 and HCPCS codes to medical records for the cardiovascular lab and interventional radiology departments based on documentation provided by physicians. Adheres to strict federal coding rules and guidelines in selecting codes that appropriately reflect the services that were provided. Balances need for (95% accuracy) coding accuracy againsttimelyaccount completion for billing deadlines.
Essential Responsibilities:
Coding of surgical procedures performed by cardiologists, and interventional radiologists
Verification of supplies used during procedures
Use of encoders and other references
Maintainsappropriate non-leading queries to physicians
Ability to abstract services from physician documentation and procedure logs.
Reconciliation of monthly surgical logs
Managing multiple job tasks daily (WQs, emails, surgical logs, census, etc.)
Prepares Excel analysis, including V-Lookups and pivot tables. Gathers and compiles data in a systematic fashion, clearly documenting assumptions, and validating accuracy of information to resolve inconsistencies.
Evaluate and implement charge requests withappropriate CPT/HCPCScodes, revenue codes, and pricing, ensuring alignment with clinical services and coding/billing guidelines.
Conducts Charge Capture Audits: Review and analyze patient records, billing data, and financial statements to ensure charge and coding compliance.Identifydiscrepancies or errors and develop action plan for future state resolution
Analyzes data toidentifylikely relationships, summarizesdataand prepares summary materialsfor discussion with clinical and finance teams.
Collaborates with various departments to resolve CDM or RI discrepancies (Utilization Management (UM), Clinical Documentation Integrity (CDI), RCM, Coding Services, Clinical Departments, and Health Information Management (HIM)).
Skills:
1.AdvancedKnowledge:CPT/HCPCS, NCCI,andMUE.
2. ExcelProficiency: Strong skills in V-Lookups and pivot tables.
3. AnalyticalSkills: Systematic data gathering, compilation, and validation.
4. Attention toDetail: Accurate documentation and data accuracy.
5. RevenueKnowledge: Understanding ofbilling and revenue recognition.
6. AuditSkills: Conducting charge capture audits andidentifyingdiscrepancies.
7. DataAnalysis: Analyzing data and summarizing findings.
8. Reporting: Running and extractingaccuratereports.
9. Collaboration:** Working with various departments (UM, CDI, RCM, etc.).
10. CommitteeParticipation:
11. Communication: Strong verbal and written skills.
12. Problem-Solving: Developing action plans for discrepancies.
13. StakeholderManagement:Interacting with stakeholders (Senior Leadership).
Other Qualifications:
Proficient computer skills (including, but not limited to, spreadsheets, Internet, and email) arerequired.
Proficiencyin Excel, including V-Lookups and pivot tables.
Strong analytical and data validation skills.
Knowledge of billing and revenue recognition processes.
Experience in conducting charge capture audits.
Ability to analyze data,identifyrelationships, and summarize findings.
Experience with report extraction from software tools.
Excellent collaboration and communication skills.
Ability to work with various departments.
Experience interacting with executive stakeholders.
Education and Experience
Education Level
High School DiplomaExperience Level
4-6 years experience
License and Certification Level
Required Certification: CCS, CIRCC, COC,CPCor equivalent
For this US-based position, the base pay range is $48,131.00 - $81,225.49 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.This job is eligible to participate in our annual bonus plan at a target of 5.00%The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.
Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a competitive benefits package.
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.
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To learn more, visit: R1RCM.com
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R1 is the leading provider of technology-driven solutions in Revenue Cycle Management (RCM), transforming the patient experience and financial performance of hospitals, health systems, and medical groups. The company combines deep revenue cycle expertise with a global delivery model and advanced technology including analytics, agentic AI, and workflow orchestration. R1's flagship product is Phare, an agentic Revenue Operating System designed to streamline financial and operational processes in healthcare. The company serves as a comprehensive partner to healthcare organizations, leveraging both a global workforce of revenue cycle professionals and sophisticated technology platforms to optimize healthcare financial operations.
