Read, interpret, and act on automated RTE responses tied to coverage and authorization outcomes
Perform root-cause analysis on coverage, eligibility, and business rule issues through resolution
Manage business rule configuration, understanding downstream impact on denials and patients
Collaborate across product, engineering, operations, coverage/eligibility, payer services, PMT, FCC, and tech deployment
Support current book of business and new client implementations
Write user stories with clear acceptance criteria
Use SQL for data analysis and troubleshooting
Create and maintain SOPs and documentation, leveraging AI tools where possible
Monitor production environments and coordinate troubleshooting with vendors and internal IT
Communicate with customers and stakeholders via ticketing systems, email, and meetings
Required Qualifications:
Real-time eligibility (RTE) experience - must be able to interpret automated eligibility responses
Medical insurance knowledge - coverage logic, eligibility, and downstream revenue cycle impact
SQL - querying, joins, tables, basic functions
Ticketing system experience (ServiceNow, ServiceDesk, or comparable)
Strong analytical skills and independent problem-solving ability
Detail-oriented with a quality-first mindset
Effective communicator across technical and non-technical teams
Requirements
Advanced Excel skills
Healthcare application support or revenue cycle experience
Experience supporting new client implementations
Interest in AI tools for process improvement and documentation
For this US-based position, the base pay range is $62,466.83 - $78,083.54 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.
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.
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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Benefits
Health insurance
Additional Information
This role supports a front-end application critical to coverage and eligibility verification, configuration management, and automation within the revenue cycle. You'll work deeply with business rules and real-time eligibility (RTE) - where your decisions directly impact denials, clients, and patients. You'll collaborate cross-functionally with product, engineering, operations, denials, payer services, patient access, and offshore teams.
R1rcm · Remote