Qualifacts is a leading provider of behavioral health software and SaaS solutions for clinical productivity, compliance and state reporting, billing, and business intelligence. Its mission is to be an cutting-edge and trusted technology and end-to-end solutions partner, enabling exceptional outcomes for its customers and those they serve. Qualifacts’ comprehensive portfolio, including the CareLogic®, Credible™, and InSync® platforms, spans and serves the entire behavioral health, rehabilitative, and human services market supporting non-profit Certified Community Behavioral Health Clinics (CCBHC) as well as for-profit large enterprise and small business providers. Qualifacts has a loyal customer base, with more than 2,500 customers representing 75,000 providers serving more than 6 million patients. Qualifacts was recognized in the 2022 and 2023 Best in KLAS: Software and Services report as having the top ranked Behavioral Health EHR solutions.
This is an onsite position, 5 days/week, in the Vadodara office.
Shift: -NIGHT/US SHIFT. 6:30pm-3:30am IST.
Remote applicants will not be considered.
Responsibilities
- Investigate AR/Denial issues: Resolve complex accounts receivable and denial cases with thorough analysis.
- Analyze denial trends: Identify recurring issues and recommend process improvements.
- Lead payer calls: Initiate and manage escalated discussions with payers to resolve disputes.
- Develop strategies: Implement solutions to reduce aging accounts and denial rates, improving reimbursement outcomes.
- Collaborate with stakeholders: Work cross-functionally to address root causes of denials.
- Mentor associates: Train and guide Level 1 team members on advanced denial management techniques.
- Prepare appeals: Draft and submit appeals for denied claims when necessary.
- Maintain documentation: Ensure comprehensive records of denial activities and outcomes.
Requirements
- Education: Associate degree in healthcare administration or related fiel
📌 RCMS AR Specialist II (Vadodara)
🏢 Qualifacts
📍 Vadodara
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