Job Description:

Responsibilities

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Investigate and resolve complex denial issues.
- Analyze denial trends to identify areas for process improvement.
- Initiate and lead payer calls for escalated denial inquiries, follow-up and disputes.
- Develop and implement strategies to reduce denial rates and improve reimbursement.
- Collaborate with internal stakeholders to address root causes of denials.
- Mentor Level 1 is associate with advanced AR/Denial management techniques.
- Prepare and submit appeals for denied claims as needed.
- Maintain comprehensive documentation of denial activities and outcomes.

Requirements:

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Associate degree in healthcare administration or related field (preferred).
- Proficiency in medical billing software and denial tracking systems.
- Solid problem-solving and analytical skills.
- Ability to effectively communicate with payers to negotiate claim resolutions.
- Leadership skills and ability to work independently.
- Attention to detail and accuracy in data analysis and reporting.

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

📌 RCMS AR Specialist I (India)
🏢 Qualifacts Systems
📍 India