Job Description:

Responsibilities

• 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.