:

Responsibilities:

- Investigate and resolve complex denial issues.

- Analyze denial trends to identify opportunities for process improvement.

- Initiate and lead payer calls for escalated denial inquiries, follow-ups, and

disputes.
- Develop and implement strategies to reduce denial rates and enhance

reimbursement.
- Collaborate with internal stakeholders to address root causes of denials.

- Prepare and submit appeals for denied claims as needed.

- Maintain comprehensive documentation of denial activities and outcomes.

- Address denials at the root cause by requesting appropriate rules and system

edits after partner approval.
- Identify and analyze denial trends and escalate to supervisor for further

resolution.

Requirements:

- Bachelor’s degree in any discipline.

- Solid problem-solving and analytical skills and work towards resolution.

- Candidates with 1-2 years of experience in Accounts Receivable (AR) & Denial

Management

Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

📌 RCMS AR Specialist II (Vadodara)
🏢 Qualifacts
📍 Vadodara