About this role
Job Description:
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. • Strong 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.