Job Description:
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 and resolve complex claim denial issues.
- Analyze denial trends and identify opportunities for process improvement.
- Initiate and lead payer calls for escalated denial inquiries, follow-ups, and dispute resolution.
- Develop and implement strategies to reduce denial rates and improve reimbursement outcomes.
- Collaborate with internal teams to identify and address the root causes of denials.
- Prepare, submit, and track appeals for denied claims.
- Maintain accurate and comprehensive documentation of denial activities, actions taken, and outcomes.
- Monitor accounts receivable and ensure timely follow-up on outstanding denials.

Requirements:
- Associate degree in Healthcare Administration or a related field preferred.
- 0-1 year of experience in Accounts Receivable (AR), Denial Management, or Revenue Cycle Management.
- Basic un

📌 Rcms Ar Specialist I (Vadodara)
🏢 Qualifacts Systems
📍 Vadodara