RCMS AR Specialist I

Qualifacts

Responsibilities

Job Description:

  • Investigate and resolve complex denial issues.
  • Analyze denial trends and 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 improve reimbursements.
  • Collaborate with internal stakeholders to address the root causes of denials.
  • Prepare and submit appeals for denied claims when necessary.
  • Maintain accurate and comprehensive documentation of denial activities and outcomes.

Requirements

  • Associate degree in Healthcare Administration, Business Administration, or a related field (preferred).
  • 0 to 1 years of experience in AR/Denial Management or Revenue Cycle Management.
  • Basic understanding of medical billing, claims processing, and denial management concepts.
  • Strong analytical and problem-solving skills.
  • Proficiency in Microsoft Office applications, particularly Microsoft Excel.
  • Excellent verbal and written communication skills.
  • Ability to manage multiple tasks and meet deadlines.
  • Strong attention to detail and accuracy.
  • Ability to work collaboratively in a team-oriented environment.
  • Willingness to learn and adapt in a fast-paced healthcare revenue cycle setting.

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

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